‘Yummy or crummy?': the multisensory components of medicines-taking among HIV-positive youth

The global rollout of Antiretroviral Treatment (ART) has revealed an urgent need to understand the medicines-taking practices of HIV-positive adolescents. In the last decade, the literature on the social determinants of health has broadened the evidence-base on ART adherence. Interdisciplinary studies have expanded conceptions of medicines-taking beyond clinical or health systems frameworks, recognising the importance of socio-structural conditions and of patients’ beliefs and experiences. Participatory research techniques which foreground the perspectives of adolescents provide greater insights still into their adherence. This article explores the use of participatory methods within a broader study on the social determinants of ART adherence among HIV-positive adolescents in South Africa. We describe how participatory methods were incorporated into this study (n = 1,059 in the quantitative baseline). We focus on an exercise, ‘Yummy or crummy?’, that explored the multisensory dimensions of medicines-taking, including their colour, smell, shape, and delivery mechanism. We describe two principal findings: first, adolescents’ preference for greater understanding of the chemical workings of medicines, manifested in their preferences for colour, taste and shape of medicines; and second, the vital relationship between sensory preferences and the social imperatives of discretion and confidentiality regarding HIV-status

Comparative Genomics of the Apicomplexan Parasites Toxoplasma gondii and Neospora caninum: Coccidia Differing in Host Range and Transmission Strategy

Toxoplasma gondii is a zoonotic protozoan parasite which infects nearly one third of the human population and is found in an extraordinary range of vertebrate hosts. Its epidemiology depends heavily on horizontal transmission, especially between rodents and its definitive host, the cat. Neospora caninum is a recently discovered close relative of Toxoplasma, whose definitive host is the dog. Both species are tissue-dwelling Coccidia and members of the phylum Apicomplexa; they share many common features, but Neospora neither infects humans nor shares the same wide host range as Toxoplasma, rather it shows a striking preference for highly efficient vertical transmission in cattle. These species therefore provide a remarkable opportunity to investigate mechanisms of host restriction, transmission strategies, virulence and zoonotic potential. We sequenced the genome of N. caninum and transcriptomes of the invasive stage of both species, undertaking an extensive comparative genomics and transcriptomics analysis. We estimate that these organisms diverged from their common ancestor around 28 million years ago and find that both genomes and gene expression are remarkably conserved. However, in N. caninum we identified an unexpected expansion of surface antigen gene families and the divergence of secreted virulence factors, including rhoptry kinases. Specifically we show that the rhoptry kinase ROP18 is pseudogenised in N. caninum and that, as a possible consequence, Neospora is unable to phosphorylate host immunity-related GTPases, as Toxoplasma does. This defense strategy is thought to be key to virulence in Toxoplasma. We conclude that the ecological niches occupied by these species are influenced by a relatively small number of gene products which operate at the host-parasite interface and that the dominance of vertical transmission in N. caninum may be associated with the evolution of reduced virulence in this species

Ankle proprioception, range of motion and drop landing ability differentiates competitive and non-competitive surfers

Objectives: To determine whether ankle proprioception differs by competitive level and is related to years of surf-specific experience. A secondary objective of this study is to further compare the physical capacities and abilities that may differentiate between the competitive levels of surfing. Design: Cross-sectional. Methods: Twelve junior-elite (currently competing at a state level or higher and 12–18 years of age), twelve senior-elite (currently competing at a national level and/or the World Qualifying Series and over 16 years of age), and twelve recreational surfers (minimum of two years surfing experience; actively surfing at least once a week and over 18 years of age) were recruited for this study. All participants completed a pre-exercise medical questionnaire, anthropometric assessment, ankle dorsiflexion range of motion assessment, medial-lateral ankle proprioception assessment, countermovement jump, squat jump, isometric mid-thigh pull and drop-and-stick. Results: Senior-elite surfers had large and significantly better ankle proprioception and range of motion than junior-elite and recreational surfers. However, the relationship between years of surf-specific experience and ankle proprioception was small and non-significant. Better drop-and-stick performance, indicated by lower relative peak force, was present in the senior-elite compared to the junior-elite and recreational groups. Conclusions: The results indicate that medial-lateral ankle proprioception is a distinguishing characteristic of senior-elite surfers and therefore, may be a critical ability for competitive success. Greater ankle range of motion and the ability to attenuate energy to reduce landing force may be developed through long-term training commensurate with competitive surfing

Ankle Proprioception in Male and Female Surfers and the Implications of Motor Experience and Lower-Body Strength

The primary objectives were to evaluate if the active movement extent discrimination apparatus (AMEDA) condition (i.e., front foot and back foot plantarflexion, dorsiflexion, inversion, and eversion) and the level of competition explained ankle movement discrimination scores and, thereafter, examined the contribution of surf experience, physical capacity, and ability to proprioception. It was also considered important to re-evaluate the surf experience, anthropometric characteristics, physical capacities, and abilities of male and female surfers. Twenty-six male (n = 12, surf experience = 18 ± 8 years) and female surfers (n = 14, surf experience = 9 ± 6 years) completed a pre-exercise medical questionnaire, anthropometric assessment, 8 AMEDA assessments, countermovement jump, squat jump, and isometric midthigh pull assessment. The AMEDA condition and level of competition did not have a statistically significant main effect on ankle movement discrimination scores; however, the effect of the gender/sex was significant (p = 0.044). Surf experience (p = 0.029) and lower-body isometric strength (p = 0.029) had a statistically significant but small main effect on ankle movement discrimination scores. The results also confirmed that there were significant differences in surf experience, anthropometric characteristics, physical capacity, and jumping ability between male and female surfers. As surf experience and physical capacity were only able to explain a small magnitude of ankle movement discrimination scores, it is suggested that ankle proprioception in surfers may be related to both the volume and quality of the motor experience attained, which may be augmented by environmental and sociocultural factors

Using trained dogs and organic semi-conducting sensors to identify asymptomatic and mild SARS-CoV-2 infections: an observational study

Background A rapid, accurate, non-invasive diagnostic screen is needed to identify people with SARS-CoV-2 infection. We investigated whether organic semi-conducting (OSC) sensors and trained dogs could distinguish between people infected with asymptomatic or mild symptoms, and uninfected individuals, and the impact of screening at ports-of-entry. Methods Odour samples were collected from adults, and SARS-CoV-2 infection status confirmed using RT-PCR. OSC sensors captured the volatile organic compound (VOC) profile of odour samples. Trained dogs were tested in a double-blind trial to determine their ability to detect differences in VOCs between infected and uninfected individuals, with sensitivity and specificity as the primary outcome. Mathematical modelling was used to investigate the impact of bio-detection dogs for screening. Results About, 3921 adults were enrolled in the study and odour samples collected from 1097 SARS-CoV-2 infected and 2031 uninfected individuals. OSC sensors were able to distinguish between SARS-CoV-2 infected individuals and uninfected, with sensitivity from 98% (95% CI 95–100) to 100% and specificity from 99% (95% CI 97–100) to 100%. Six dogs were able to distinguish between samples with sensitivity ranging from 82% (95% CI 76–87) to 94% (95% CI 89–98) and specificity ranging from 76% (95% CI 70–82) to 92% (95% CI 88–96). Mathematical modelling suggests that dog screening plus a confirmatory PCR test could detect up to 89% of SARS-CoV-2 infections, averting up to 2.2 times as much transmission compared to isolation of symptomatic individuals only. Conclusions People infected with SARS-CoV-2, with asymptomatic or mild symptoms, have a distinct odour that can be identified by sensors and trained dogs with a high degree of accuracy. Odour-based diagnostics using sensors and/or dogs may prove a rapid and effective tool for screening large numbers of people