A decade of tobacco control: The South African case of politics, health policy, health promotion and behaviour change

BACKGROUND: The South African (SA) government has implemented comprehensive tobacco control measures in line with the requirements of the Framework Convention on Tobacco Control. The effect of these measures on smoking prevalence and smoking-related attitudes, particularly among young people, is largely unknown. OBJECTIVE: To describe the impact of a comprehensive health promotion approach to tobacco control amongst SA school learners. METHODS: Four successive cross-sectional Global Youth Tobacco Surveys (GYTSs) were conducted in 1999, 2002, 2008 and 2011 among nationally representative samples of SA grades 8 - 10 school learners. We assessed the prevalence of current smoking (having smoked a cigarette on ≥1 day in the 30 days preceding the survey) and smoking-related attitudes and behaviours. RESULTS: Over the 12-year survey period current smoking among learners declined from 23.0% (1999) to 16.9% (2011) - a 26.5% reduction. Reductions in smoking prevalence were less pronounced amongst girls and amongst black learners. We observed an increase in smoking prevalence amongst learners between 2008 and 2011. Smoking-related attitudes and behaviours showed favourable changes over the survey period. CONCLUSION: These surveys demonstrate that the comprehensive and inter-sectorial tobacco control health promotion strategies implemented in SA have led to a gradual reduction in cigarette use amongst school learners. Of concern, however, are the smaller reductions in smoking prevalence amongst girls and black learners and an increase in smoking prevalence from 2008 to 2011. Additional efforts, especially for girls, are needed to ensure continued reduction in smoking prevalence amongst SA youth

Development of a hairy root bioreactor from Stevia rebaudiana to produce steviol glycosides

Thesis (MScAgric)--Stellenbosch University, 2017.ENGLISH SUMMARY: Extracts from the leaves of Stevia rebaudiana, a plant native to South America, have been used as natural sweetener for centuries. With the global epidemic of obesity linked to increased prevalence of diabetes, Stevia has attracted interest for use as a non-nutritive sweetener (NNS). Unlike currently available NNS which are chemically synthesised (e.g. sucralose), Stevia extracts represent naturally occurring NNS with no negative side effects from its use. The sweet-to-taste compounds in Stevia are actually due to the accumulation of secondary metabolites in the leaves, specifically two steviol glycosides (SGs, stevioside and rebaudioside A). However, these SGs occur in low concentrations (between 2-4% of total fresh weight) and show variability in plants grown by commercial scale agricultural propagation. The plant also requires high irrigation inputs owing to its sensitivity to even moderate water deficit. Stevia is currently not a cash crop in South Africa (SA) but there is interest in establishing commercial scale agricultural ventures to establish a Stevia economy. SA is also experiencing a concerning rise in the number of new incidences of diabetes amongst its population and recently approved the introduction of a sugar tax that is envisaged to reduce this excessive sugar intake and over time improve the health and well-being of the population. The variable SG yields and the high irrigation inputs required to produce them from the plant are considered major restrictive factors toward establishment of a Stevia economy in SA - a naturally water scarce country. Current propagation methods for Stevia are both laborious and costly because the seeds are recalcitrant and plants have to be propagated via stem cuttings or in vitro tissue culture. Hairy root cultures have been widely used in plants of medicinal importance to obtain high quantities of bioactive secondary metabolites, for use as pharmaceutical drugs. Agrobacterium rhizogenes is utilised in this context to induce hairy root formation and a few studies have investigated Stevia hairy root cultures but none have reported SG accumulation in these cultures. This study attempted to create Stevia hairy root cultures expressing key genes in the SG biosynthesis pathway and accumulating the two sweet SGs, stevioside and rebaudioside A. Additionally, attempts were made to create Stevia hairy root cultures overexpressing UGT74G1 and UGT76G1 (the two genes responsible for stevioside and rebaudioside A accumulation respectively) with the intention of increasing SG production.. Although we demonstrated that A. rhizogenes could be transformed with the plant expression constructs and that this transformed A. rhizogenes could induce hairy roots from leaf explants, tandem mass spectrometry analyses of root extracts did not identify either stevioside or rebaudioside A. We suspect that the lack of photosynthetic capacity in hairy root cultures resulted in the unavailability of key intermediate substrates for SG biosynthesis that have been proposed to be produced during photosynthesis. However, we are currently investigating if these hairy root cultures could be primed for SG accumulation by growing them in the presence of the proposed intermediate substrates which are available commercially at low cost.AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar nie

IsiZulu Terminology Development in Nursing and Midwifery

Abstract The Education White Paper of 1997 on transformation in higher education in South Africa (South Africa 1997) indicated that because of the multilingual nature of the diverse communities in the new democracy, higher education should play a role in the development of all the official languages including the indigenous languages, as well as the Khoi, Nama, San and Sign languages. The School of Nursing of the University of KwaZulu-Natal took this obligation to heart by participating in the SANTED multilingualism project. This emanated from the needs of the student nurses who are being educated and trained in English, but serve in communities where Zulu is the dominant language. To meet the identified student needs, the nursing and midwifery specialists, in collaboration with various language specialists in KwaZulu-Natal, engaged in a process to develop terminology which enhances isiZulu as a scientific language. This article discusses the language policies and multilingual trends, both locally and globally and describes the experiences of the nursing specialists who participated in the terminology development process. The main categories for deriving terms based on the linguistic decisions made by the team are also described, and examples provided. The challenges are outlined and the recommendations include the importance of institutional buy-in at all academic levels and strategies for the sustainability of the project

‘Treating a patient should be approached in a holistic manner’: collaboration of doctors and physiotherapists in the rehabilitation of people living with HIV

People living with HIV facing impairments and subsequent disabilities related to the virus and its treatment require involvement of a collaborative team of healthcare professionals to ensure reintegration into daily life and community living. Healthcare teams responsible for this care include doctors and physiotherapists. This paper explores the collaboration of doctors and physiotherapists in the rehabilitation of people living with HIV in a semi-rural healthcare setting in KwaZulu-Natal, South Africa. Six doctors and two physiotherapists were interviewed using a semi-structured interview guide. The qualitative approach led to the emergence of five themes, namely a biomedical versus biopsychosocial approach; scope of practice challenge; multidisciplinary team enigma; institutional structure limitations; and recommendations from healthcare professionals. Both groups of professionals believed that a lack of understanding of the scope of practice and role of the associate profession in the multidisciplinary team led to poor referrals and lack of communication. Furthermore, shortage of personnel and resource limitations posed barriers to effective team interaction. Timely referrals, good communication and understanding of roles were suggested as endorsements to improved collaboration