Taking HIV testing to families: designing a family-based intervention to facilitate HIV testing, disclosure and intergenerational communication

Introduction: Facility-based HIV testing does not capture many adults and children who are at risk of HIV in South Africa. This underscores the need to provide targeted, age-appropriate HIV testing for children, adolescents and adults who are not accessing health facilities. While home based counseling and testing has been succesfully delivered in multiple settings, it also often fails to engage adolescents. To date, the full potential for testing entire families and linking them to treatment has not been evaluated. Methods: The steps to expand a successful home-based counseling and testing model to a family-based counseling and testing approach in a high HIV prevalence context in rural South Africa are described. The primary aim of this family-based model is to increase uptake of HIV testing and linkage to care for all family members, through promoting family cohesion and intergenerational communication, increasing HIV disclosure in the family, and improving antiretroviral treatment uptake, adherence and retention. We discuss the three-phased research approach that led to the development of the family-based counseling and testing intervention. Results: The family-based intervention is designed with a maximum of five sessions, depending on the configuration of the family (young, mixed and older families). There is an optional additional session for high-risk or vulnerable family situations. These sessions encourage HIV testing of adults, children and adolescents and disclosure of HIV status. Families with adolescents receive an intensive training session on intergenerational communication, identified as the key causal pathway to improve testing, linkage to care, disclosure and reduced stigma for this group. The rationale for the focus on intergenerational communication is described in relation to our formative work as well as previous literature, and potential challenges with pilot testing the intervention are explored. Conclusion: This paper maps the process for adapting a novel and largely successful home-based counseling and testing intervention for use with families. Expanding the successful home-based counseling and testing model to capture children, adolescents and men could have significant impact if the pilot is successful and scaled-up

Can we prevent antimicrobial resistance by using antimicrobials better?

Since their development over 60 years ago, antimicrobials have become an integral part of healthcare practice worldwide. Recently, this has been put in jeopardy by the emergence of widespread antimicrobial resistance, which is one of the major problems facing modern medicine. In the past, the development of new antimicrobials kept us one step ahead of the problem of resistance, but only three new classes of antimicrobials have reached the market in the last thirty years. A time is therefore approaching when we may not have effective treatment against bacterial infections, particularly for those that are caused by Gram-negative organisms. An important strategy to reduce the development of antimicrobial resistance is to use antimicrobials more appropriately, in ways that will prevent resistance. This involves a consideration of the pharmacokinetic and pharmacodynamics properties of antimicrobials, the possible use of combinations, and more appropriate choice of antimicrobials, which may include rapid diagnostic testing and antimicrobial cycling. Examples given in this review include Mycobacterium tuberculosis, Gram-negative and Gram-positive organisms. We shall summarise the current evidence for these strategies and outline areas for future development

The implications of model–informed drug discovery and development for tuberculosis

The research leading to these results received support from the Innovative Medicines Initiative Joint Undertaking under grant agreement n°115337, the resources of which comprise financial contributions from the European Union's Seventh Framework Programme (FP7/2007-2013) and EFPIA companies’ in kind contribution.Despite promising advances in the field and highly effective first-line treatment, an estimated 9.6 million people are still infected with tuberculosis (TB). Innovative methods are required to effectively transition the growing number of compounds into novel combination regimens. However, progression of compounds into patients occurs despite the lack of clear understanding of the pharmacokinetic-pharmacodynamic (PK/PD) relations. The PreDiCT-TB consortium was established in response to the existing gaps in TB drug development. The aim of the consortium is to develop new preclinical tools in concert with an in silico model-based approach, grounded in PKPD principles. Here, we highlight the potential impact of such an integrated framework on various stages in TB drug development and on the dose rationale for drug combinations.PostprintPeer reviewe

Іконографічні розвідки родинних портретів Рєпніних з Яготина (На матеріалах колекції Національного музею історії України)

Статтю присвячено дослідженню родинних портретів князів Рєпніних з яготинського маєтку в Національному музеї історії України. Портрети становлять важливе іконографічне джерело XVII – XX ст. в системі історичних дисциплін.The article is dedicated to research family portraits of the Repnin а princes from Jаgotinscka palace in The National museum of history of Ukraine. The portraits become are important iconography source XVII–XX cent. in the system historical branches of science

An exploration of the criteria used by educators in the identification of children with attention related problems.

Masters Degree. University of KwaZulu-Natal, Durban.The main purpose of this study was to determine the extent to which educators were able to identify behavioural descriptors pertaining to Attention Deficit Hyperactivity Disorder (ADHD) as outlined in the DSM-IV and to explore the management strategies employed by educators in the classroom in their attempt to deal with the disorder. The participants were 36 Foundation Phase educators (grades 1 to 3) in the South Durban Region. An analysis of data obtained from the administration of questionnaires to educators indicated that, although educators were able to identify behavioural criteria descriptive of ADHD, they were unable to differentiate between ADHD and Oppositional Defiant Disorder (ODD). They viewed the disorders as interrelated. However, they showed insight into the difficulties experienced by ADHD learners. This was evident in the effective classroom management practices educators adopted to deal with these special learners. Finally, knowledge of ADHD and qualification level appeared to have no impact on accuracy of educators' ratings

ISSUES IN MEDICINE: Models for increasing the health workforce

A stable human resource base in the health sector is critical to achieving health-related Millennium Development Goals. There is a severe quantitative and qualitative shortfall of healthcare professionals in South Africa, and the existing and future health workforce production is inadequate for our healthcare needs. The production model must include all healthcare disciplines because the quadruple burden of disease necessitates multi-professional healthcare teams working synergistically to improve healthoutcomes and life expectancy

Bioprospecting Red Sea Coastal Ecosystems for Culturable Microorganisms and Their Antimicrobial Potential

Microorganisms that inhabit unchartered unique soil such as in the highly saline and hot Red Sea lagoons on the Saudi Arabian coastline, represent untapped sources of potentially new bioactive compounds. In this study, a culture-dependent approach was applied to three types of sediments: mangrove mud (MN), microbial mat (MM), and barren soil (BS), collected from Rabigh harbor lagoon (RHL) and Al-Kharrar lagoon (AKL). The isolated bacteria were evaluated for their potential to produce bioactive compounds. The phylogenetic characterization of 251 bacterial isolates based on the 16S rRNA gene sequencing, supported their assignment to five different phyla: Proteobacteria, Firmicutes, Actinobacteria, Bacteroidetes, and Planctomycetes. Fifteen putative novel species were identified based on a 16S rRNA gene sequence similarity to other strain sequences in the NCBI database, being ≤98%. We demonstrate that 49 of the 251 isolates exhibit the potential to produce antimicrobial compounds. Additionally, at least one type of biosynthetic gene sequence, responsible for the synthesis of secondary metabolites, was recovered from 25 of the 49 isolates. Moreover, 10 of the isolates had a growth inhibition effect towards Staphylococcus aureus, Salmonella typhimurium and Pseudomonas syringae. We report the previously unknown antimicrobial activity of B. borstelensis, P. dendritiformis and M. salipaludis against all three indicator pathogens. Our study demonstrates the evidence of diverse cultured microbes associated with the Red Sea harbor/lagoon environments and their potential to produce antimicrobial compounds

Exploring grade 11 learner routines on function from a commognitive perspective

A thesis submitted to the Faculty of Humanities, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy September 2015This study explores the mathematical discourse of Grade 11 learners on the topic function through their routines. From a commognitive perspective, it describes routines in terms of exploration and ritual. Data was collected through in-depth interviews with 18 pairs of learners, from six South African secondary schools, capturing a landscape of public schooling, where poor performance in Mathematics predominates. The questions pursued became: why does poor performance persist and what might a commognitive lens bring into view? With the discursive turn in education research, commognition provides an alternate view of learning mathematics. With the emphasis on participation and not on constraints from inherited mental ability, the study explored the nature of learner discourse on the object, function. Function was chosen as it holds significant time and weight in the secondary school curriculum. Examining learners’ mathematical routines with the object was a way to look at their discourse development: what were the signifiers related to the object and what these made possible for learners to realise. Within learners’ routines, I was able to characterise these realisations, which were described and categorised. This enabled a description of learner thinking over three signifiers of function in school Mathematics: the algebraic expression, table and graph. In each school, Grade 11 learners were separated into three groups according to the levels at which they were performing, from summative scores of grade 11 assessments, so as to enable a description of discourse related to performance. Interviews were conducted in pairs, and designed to provoke discussion on aspects of function and its signifiers between learners in each pair. This communication between learners and with the interviewer provided data for description and analysis of rituals and explorations. Zooming in and out again on these routines made a characterisation of the discourse of failure possible, which is seldom done. It became apparent early in the study that learners talked of the object function, without a formal mathematical narrative, a definition in other words, of the object. The object was thus vested in its signifiers. The absence of an individualised formal narrative of the object impacts directly what is made possible for learners to realise, hence to learn. The study makes the following contributions: first, it describes learners’ discursive routines as they work with the object function. Second, it characterises the discourse of learners at different levels of performance. Third, it starts exploration of commognition as an alternate means to look at poor performance. The strengths and limitations of the theory as it pertains to this study, are discussed later in the concluding chapter. Keywords commognition, discourse, communication, participation, routines, exploration, ritual, learners, learning, narratives, endorsed narratives, visual mediators

Material parameter identification for modelling the left ventricle in the healthy state

Includes bibliographical references.An idealized truncated ellipsoidal model, was used to simulate a healthy canine left ventricle. Passive behaviour of the myocardium was modelled using the constitutive model of Usyk. In addition, active behaviour of the myocardium was modelled by the active stress law of Guccione. Furthermore, the load faced by the left ventricle in ejecting blood into the arterial system, was modelled with the three element Windkessel model of Westerhof. The model was calibrated to pressure-volume data, which was adaptedfrom the work of Kerckhoffs. The projected Levenberg-Marquardt algorithm was used to identify material parameters. Identification of the anisotropic constants in the model of Usyk proved to be difficult, with the calibration algorithm often converging to parameter values that produced numerical instability. An idealized truncated ellipsoidal model, was used to simulate a healthy canine left ventricle. Passive behaviour of the myocardium was modelled using the constitutive model of Usyk. In addition, active behaviour of the myocardium was modelled by theactive stress law of Guccione. Furthermore, the load faced by the left ventricle in ejecting blood into the arterial system, was modelled with the three element Windkessel model of Westerhof. The model was calibrated to pressure-volume data, which was adapted from the work of Kerckhoffs. The projected Levenberg-Marquardt algorithm was used to identify material parameters. Identification of the anisotropic constants in the model of Usyk proved to be difficult, with the calibration algorithm often converging to parameter values that produced numerical instability. An idealized truncated ellipsoidal model, was used to simulate a healthy canine left ventricle. Passive behaviour of the myocardium was modelled using the constitutive model of Usyk. In addition, active behaviour of the myocardium was modelled by the active stress law of Guccione. Furthermore, the load faced by the left ventricle in ejecting blood into the arterial system, was modelled with the three element Windkessel model of Westerhof. The model was calibrated to pressure-volume data, which was adaptedfrom the work of Kerckhoffs. The projected Levenberg-Marquardt algorithm was used to identify material parameters. Identification of the anisotropic constants in the model of Usyk proved to be difficult, with the calibration algorithm often converging to parameter values that produced numerical instability. An idealized truncated ellipsoidal model, was used to simulate a healthy canine left ventricle. Passive behaviour of the myocardium was modelled using the constitutive model of Usyk. In addition, active behaviour of the myocardium was modelled by the active stress law of Guccione. Furthermore, the load faced by the left ventricle in ejecting blood into the arterial system, was modelled with the three element Windkessel model of Westerhof. The model was calibrated to pressure-volume data, which was adapted from the work of Kerckhoffs. The projected Levenberg-Marquardt algorithm was used to identify material parameters. Identification of the anisotropic constants in the model of Usyk proved to be difficult, with the calibration algorithm often converging to parameter values that produced numerical instability

Liberatory Education: Unmasking Apartheids Pedagogical Plunder The South African Liberation Struggle (1912 – 1990)

This study creates the possibility of providing a template for an interactive and participatory resource where activists, scholars and the general populous can converge into a dialogue highlighting the role of ordinary citizens in the formulation and conception of their own history and how this historicity has informed the development and trajectory of the South African (and other) National Liberation Struggle/s