Perceptions of postpartum mothers towards the care provided by male student midwives at labour units in Limpopo Province, South Africa

Student midwives should always provide cultural sensitive care and respect the rights of every woman when choosing health care providers during pregnancy and childbirth. The aim of this study was to describe and explore the perceptions of postpartum mothers towards the care provided by male student midwives during their midwifery practice. A qualitative explorative, descriptive, and contextual research design was used. A non-probability, convenience sampling method was used to sample 42 postpartum mothers who received care from male student midwives at the five district hospitals in Limpopo province, South Africa. Data was collected through in-depth individual interviews until data saturation was reached by repeating data. Open coding approach was used to analyse data. All ethical principles were adhered to. Results revealed that postpartum mothers, preferred care by male students‘ midwives; they were viewed to be respectful, sympathetic, and caring; however, they discussed their fears of midwifery practice with mothers. It is recommended that midwives should play a pivotal role in informing pregnant women during antenatal visits that male student midwives can conduct deliveries. The community awareness campaign should be strengthened that male student midwives are availability in maternity units.Keywords: Male student midwives, midwifery practice, perceptions, and postpartum mother

Cost-Effective Filter Materials Coated with Silver Nanoparticles for the Removal of Pathogenic Bacteria in Groundwater

The contamination of groundwater sources by pathogenic bacteria poses a public health concern to communities who depend totally on this water supply. In the present study, potentially low-cost filter materials coated with silver nanoparticles were developed for the disinfection of groundwater. Silver nanoparticles were deposited on zeolite, sand, fibreglass, anion and cation resin substrates in various concentrations (0.01 mM, 0.03 mM, 0.05 mM and 0.1 mM) of AgNO3. These substrates were characterised by SEM, EDS, TEM, particle size distribution and XRD analyses. In the first phase, the five substrates coated with various concentrations of AgNO3 were tested against E. coli spiked in synthetic water to determine the best loading concentration that could remove pathogenic bacteria completely from test water. The results revealed that all filters were able to decrease the concentration of E. coli from synthetic water, with a higher removal efficiency achieved at 0.1 mM (21–100%) and a lower efficiency at 0.01 mM (7–50%) concentrations. The cation resin-silver nanoparticle filter was found to remove this pathogenic bacterium at the highest rate, namely 100%. In the second phase, only the best performing concentration of 0.1 mM was considered and tested against presumptive E. coli, S. typhimurium, S. dysenteriae and V. cholerae from groundwater. The results revealed the highest bacteria removal efficiency by the Ag/cation resin filter with complete (100%) removal of all targeted bacteria and the lowest by the Ag/zeolite filter with an 8% to 67% removal rate. This study therefore suggests that the filter system with Ag/cation resin substrate can be used as a potential alternative cost-effective filter for the disinfection of groundwater and production of safe drinking water

If not now, when? Time for the European Union to define a global health strategy

Speakman, E. M., McKee, M., & Coker, R. (2017). If not now, when? Time for the European Union to define a global health strategy. Lancet Global Health, 5(4), e392-e393. https://doi.org/10.1016/S2214-109X%2817%2930085-

Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial

Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402

Evaluation of the accuracy of the Asanté assay as a point-of-care rapid test for HIV-1 recent infections using serum bank specimens from blood donors in South Africa, July 2018 - August 2021

Background. Point-of-care (POC) rapid recency testing can be used as a cost-effective tool to identify recently infected individuals (i.e. infected within the last 12 months) in near-real time, support epidemic control and identify hotspots for transmission as part of recent infection surveillance. Objective. To evaluate the performance of the Asanté (HIV-1) rapid recency assay as a POC rapid test among blood donors in South Africa (SA). Methods. The study was a cross-sectional and validity study of the Asanté HIV-1 Rapid Recency Assay performed on 715 consecutively archived plasma donor specimens from the SA National Blood Services to determine their recency and established HIV infection status. ELISA and rapid assays for HIV antibody detection were used as the reference-testing standard for confirming an infection, while the Maxim HIV-1 limiting antigen (LAg) avidity assay was used as a reference for comparing HIV recency status. Validity tests (sensitivity, specificity, negative and positive predictive values) and Cohen-Kappa tests of the agreement were conducted to compare the Asanté HIV-1 rapid recency assay results with the reference tests. Results. Of the 715 studied blood samples, 63.1% (n=451/715) were confirmed to be HIV-positive based on the reference standard. The sensitivity and specificity of the Asanté HIV-1 rapid recency assay in diagnosing established HIV infection compared to the ELISA were 98.4% (95% CI 96.7 - 99.3) and 99.6% (95% CI 97.6 - 100), respectively. Compared with HIV rapid assay, the sensitivity and specificity of the Asanté HIV-1 rapid recency assay was 98.7% (95% CI 97.0 - 99.4) and 99.2% (95% CI 97.1 - 100), respectively. Of the 451 HIV-positive blood samples, 43% were confirmed as recent HIV infections by the Maxim HIV-1 LAg avidity assay. There was high agreement between the Asanté HIV-1 rapid recency assay and the Maxim HIV-1 LAg avidity assay (94.1%, k=0.879, p<0.0001). The sensitivity and specificity of the Asante HIV-1 assay was 89.4% (95% CI 84.0 - 93.0) and 97.7% (95% CI 94.8 - 99.0), respectively. Conclusion. The Asanté HIV-1 rapid recency assay test results demonstrated high accuracy (>90%) compared with the HIV ELISA and rapid assays for determining established infection and the Maxim HIV-1 LAg avidity assay for classifying recent HIV-1 infections. The assay’s sensitivity for established infections was below the World Health Organization criteria (<99%) for POC devices. The Asanté HIV-1 rapid recency assay can be used to distinguish between recent and long-term infections, but may not be considered a POC test for determining HIV infection

The synergistic fouling of ceramic membranes by particles and natural organic matter fractions using different surface waters in South Africa

This study demonstrates the fundamental differences in fouling development and mechanisms of unfiltered and 0.45 µm pre-filtered water samples on ceramic membranes. Robust characterization of the feed waters was conducted using gravimetric analysis, optical methods and modeling techniques. UV254 removal and suspended solids (SS) for the unfiltered samples presented a strong correlation (R2 = 0.87). Further, SS exhibited strong correlations with fluorescent fractions (R2 = 0.82; 0.81 and 0.74 for C1; C2 and C3, respectively). This observation confirmed the significance of inorganic particles in the development of a combined fouling layer with fluorescent organic components. The fouling development rate for water sampled from Plattenburg Bay (PL) was higher than the rest of the 0.45 µm pre-filtered samples. This was attributed to the low conductivity (175 µS.m-1) of the water sample, translating to a low ionic strength environment. Samples collected from Hermanus River (HL) and Lepelle River (OL) had similar SS quantity (87.6 mg/L and 88.4 mg/L, respectively), and modified fouling index (MFI) values for raw samples were 6625 and 8060 s/L2, respectively, despite a very large difference in the content of organic matter (22.67 mg/L.C and 9.81 mg/L.C). This could be due to organic matter attaching onto the surface of particles and reducing the adsorption of NOM within membrane pores and/or onto the membrane active layer. This study demonstrated the extent of in situ background electrolytes, foulant concentration, foulant-foulant interactions, foulant-membrane interaction and physicochemical properties of feed stream on fouling development and mechanisms.</p

Synthesis, characterization, and antimicrobial activity of poly(GMA-co-EGDMA) polymer decorated with silver nanoparticles

Composite consisting of silver nanoparticles coordinated to poly(GMA-co-EGDMA) macroporous copolymer was prepared by attachment of amino group to the poly(GMA-co-EGDMA) in the reaction with ethylene diamine, and consequent reduction of silver ions with amino groups at elevated temperature. The infrared measurements indicated that surface of silver nanoparticles is passivated through the coordination of the lone pair on the N atom of the imine present in the skeleton of the poly(GMA-co-EGDMA) copolymer. The inductively coupled plasma atomic emission, UV-Vis reflection spectroscopy, X-ray diffraction, and transmission electron microscopy measurements revealed the high content (52 wt%) of well-separated silver nanoparticles in the size range of 5-10 nm onto composite. Antimicrobial efficiency of composite was tested against Gram-negative bacteria E. coli, Gram-positive bacteria S. aureus, and fungus C. albicans in wide concentration range of composite. The composite ensured almost maximum reduction of both bacteria, while the fungi reduction reached 96.5 %