The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Learning styles of physiotherapists : a systematic scoping review

CITATION: Stander, J., Grimmer, K. & Brink, Y. 2019. Learning styles of physiotherapists : a systematic scoping review. BMC Medical Education, 19:2, doi:10.1186/s12909-018-1434-5.The original publication is available at https://bmcmededuc.biomedcentral.comBackground: Understanding students’ learning styles, and modifying teaching styles and material accordingly, is an essential to delivering quality education. Knowing more about the learning styles of physiotherapy learners will assist educators’ planning and delivering of learning activities. The purpose of this scoping review was to explore what is published about physiotherapy learning styles. Methods: An adapted Arksey and O’Malley framework was applied to undertake this systematic scoping review. Nine electronic databases (CINAHL, BIOMED CENTRAL, Cochrane, Web of Science, PROQUEST, PubMed, OTseeker, Scopus, ERIC) were searched using the keywords: ‘learning styles’ and ‘physiotherapy’. English-language, primary research articles that investigated physiotherapy learners’ learning styles were sought. Results: Of 396 potentially-relevant articles, 15 were included in this review. The studies mostly reflected undergraduate students (910 undergraduates, 361 postgraduates, 23 professionals), in developed countries. Nine articles used the Kolb’s experiential learning theory (ELT); one study applied Honey and Mumford’s approach; two studies used the Gregorc model of cognition and three studies did not specify an underlying theory. Outcome measures included different versions of Kolb’s Learning Style Inventory, the visual-aural-read/write-kinesthetic questionnaire, Gregorc style delineator, Felder Silverman’s Index of Learning Survey, and Honey and Mumford’s Learning Style Questionnaire. The preferred physiotherapy learning styles, according to the ELT, seem to be Converger (learns “hands-on” and applying previously attained knowledge) and Assimilator (gathers and organises information to make the most sense). Conclusions: Both physiotherapy learners and physiotherapists have specific learning styles of active participation, underpinned with practical examples of theoretical concepts. More research is needed in developing countries, and on postgraduate and professional physiotherapy learners’ learning styles. Also, further research should focus on defining and describing physiotherapy learning styles in a way to be used as an industry standard; and developing valid and reliable learning style outcome measures applicable across physiotherapy learners and settings.https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-018-1434-5Publisher's versio

Additional file 2: of Training programmes to improve evidence uptake and utilisation by physiotherapists: a systematic scoping review

Articles excluded after applying inclusion and exclusion criteria, This additional file supplies the reasons for each article after applying inclusion and exclusion criteria. (DOCX 14 kb

Efficacy of devices in teaching spinal mobilisation skills: A scoping review protocol

Introduction: Physiotherapy students are required to develop psychomotor skills essential for the assessment and treatment of patients with back pain. The technique involves generating forces on the spine to feel the level of intervertebral movement. Objective: The objective of this scoping review is to understand the extent and type of evidence in relation to the efficacy of manual devices used for teaching spinal manual therapy skills in tertiary education settings. Methods: A systematic scoping review will be conducted following the Joanna Briggs framework for scoping reviews. This review aims to map the concept, context, and measures of the efficacy of manual devices in their contribution to teaching spinal mobilisation skills. We will conduct an electronic database search (e.g., MEDLINE, CINAHL, Web of Science, Embase, Cochrane Database), a search of the grey literature (e.g., PROSPERO, OpenGrey, EThOS e-theses online service) and handsearching the identified articles’ reference lists. This review will seek English-language, full text primary or secondary research articles of any research design. There will be no time restrictions placed on the searches. A purpose-built data extraction tool will be designed in a Microsoft Excel spreadsheet. The inclusion criteria following the participants, concept, and context (PCC) framework include higher education students that have been exposed to and used manual devices to affect their skills in manual mobilisation of the spine during their training in the field of musculoskeletal health. Overarching review question: What is reported in the literature regarding the efficacy of manual/ haptic devices for teaching spinal manual therapy psychomotor skills in tertiary education? Discussion: The results of this scoping review will inform the continued development and evaluation of a manual device designed to assist training physiotherapy students in spinal manual therapy and force generation parameters during spinal manual therapy techniques

Effect of exercise versus cognitive behavioural therapy or no intervention on anxiety, depression, fitness and quality of life in adults with previous methamphetamine dependency : a systematic review

CITATION: Morris, L., et al. 2018. Effect of exercise versus cognitive behavioural therapy or no intervention on anxiety, depression, fitness and quality of life in adults with previous methamphetamine dependency : a systematic review. Addiction Science and Clinical Practice, 13:4, doi:10.1186/s13722-018-0106-4.The original publication is available at https://ascpjournal.biomedcentral.comBackground: Methamphetamine (MA) is a highly addictive psychostimulant used by approximately 52 million people worldwide. Chronic MA abuse leads to detrimental physiological and neurological changes, as well as increases in anxiety and depression, and decreases in overall fitness and quality of life. Exercise has been reported to possibly reverse physiological and neurological damage caused by previous MA use, and to reduce anxiety and depression in this population. The aim of this systematic review was to identify, clinically appraise and synthesise the available evidence for the effectiveness of exercise, compared to cognitive behavioural therapy (CBT), standard care or no intervention, on decreasing anxiety and depression and improving fitness and quality of life in previous MA users. Methods: Seven computerised databases were searched from inception to May 2017, namely Scopus, Cochrane Library, PubMed/MEDLINE, PEDro, CINAHL, and ScienceDirect. Search terms included exercise, methamphetamine, fitness measures, depression, anxiety and quality of life. Randomised and non-randomised controlled- or clinical trials and pilot studies, published in English, were considered for inclusion. Methodological quality was critically appraised according to the PEDro scale. Heterogeneity across studies regarding control groups and assessment intervals rendered meta analyses inappropriate for this review and results were thus described narratively using text and tables. Results: Two hundred and fifty-one titles were identified following the initial search, and 14 potentially-relevant titles were selected and the abstracts reviewed. Three studies (two randomised controlled trials and one quasi-experimental pilot) were included, with an average PEDro score of 6.66. Exercise resulted in significantly lower depression and anxiety scores versus CBT (p = 0.001). Balance also significantly improved following exercise versus standard care (p < 0.001); as did vital capacity, hand-grip and one-leg stand with eyes closed. There were significant changes in all subdivisions of the Quality of Life Scale Questionnaire (p < 0.05), except psychology (p = 0.227). Conclusions: Level II evidence suggests that exercise is effective in reducing anxiety and depression and improving fitness in previous MA users, and Level III-2 evidence suggests that exercise is beneficial for improving quality of life in this population. Overall recovery in previous MA dependents might be significantly enhanced by including exercise in the rehabilitation process. Further research is required to strengthen these conclusions and to inform policy and health systems effectively.https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-018-0106-4Publisher's versio