Effects of HIV status and linguistic medium on the test performance of rural low-literacy adults: implications for neuropsychological test development in Zambia

Purpose of the study: The purpose of the study was to determine whether the familiar language (Chichewa version) could contribute to the early diagnosis of neurocognitive dysfunctions and develop a battery of locally valid tests capable of detecting early changes in the cognitive profile of neurocognitive dysfunctions among HIV positive patients.Research question one: What is the difference in performance between HIV negative and HIV positive individuals when they are subjected to the four verbal tests of the neuropsychological test battery using the English and Chichewa versions?Research question two: What is the interaction effect among the influences of HIV status, linguistic medium and gender on the four verbal tests of the neuropsychological test battery?Design: It was an experimental design that assessed the neuropsychological effects of HIV status and linguistic medium on the test performance. The Hopkins Verbal Learning Test (HVLT-R) for both immediate and delayed recall were used to test the verbal episodic memory from the Verbal Learning and Memory Recall Domain (Brandt and Benedict, 2001). Other tests included Animal and Action Naming. These tests were translated into Chichewa and administered to 28 HIV positive and 22 HIV negative rural low illiterate adults aged between 40 and 65 years.Results: On all the Neuropsychological tests administered, HIV positive respondents scored significantly lower than HIV negative respondents, and the mean scores on the English medium version were consistently lower than scores on the L1 (Chichewa) version across all tests and all groups.Conclusion: The study has shown that the primary language is best suited to test neurocognitive performance and especially when one is using test components that do not require reading or writing

Evaluating LAB@FUTURE, a collaborative e-learning Laboratory experiments platform

This paper presents Lab@Future, an advanced e-learning platform that uses novel Information and Communication Technologies to support and expand laboratory teaching practices. For this purpose, Lab@Future uses real and computer generated objects that are interfaced using mechatronic systems, augmented reality, mobile technologies and 3D multi user environments. The main aim is to develop and demonstrate technological support for practical experiments in the following focused disciplines namely: Fluid Dynamics - Science subject in Germany, Geometry - Mathematics subject in Austria, History and Environmental Awareness – Arts and Humanities subjects in Greece and Slovenia. In order to pedagogically enhance the design and functional aspects of this e-learning technology, we are investigating the dialogical operationalisation of learning theories so as to leverage our understanding of teaching and learning practices in the targeted context of deployment. To be able to evaluate the lab@future system in its entire complexity an evaluation methodology including several phases has been developed, performing formative as well as summative evaluations

Solar photovoltaic energy progress in Zambia : a review

Abstract: Regionally, Southern Africa is facing many challenges with regard to the level of access to energy. The situation is most compounded in the rural areas where poverty and lack of development are taking place at a snail pace. In order to achieve and promote sustainable development, the use of solar energy has been regarded by the government of Zambia and the sub-Saharan African region as the best alternative to the current energy deficit that the region is facing. To begin with, the government of Zambia, in the last decade, has supported solar photovoltaic energy research and development. However, the country has had challenges with achieving the set targets of connecting 10,000 new household by 2013 and ended up reducing the target to 2500 households of which 500 household of the proposed target was connected in 2015. This review is a desktop study of the on-going research on the solar energy and policy analysis of Zambia. It reviews the current solar photovoltaic and renewable energy trends in Zambia based on secondary data collected from various literatures, reports, and local contacts. The paper also highlights some of the solar energy achievements and failures in Zambia such as the 50MW solar mini-grid with the lowest tariff of US$0.0602 unit per kilowatt-hour and as well as the efforts, the government of Zambia has made through the help of international donors and the World Bank to scale up initiatives. Finally, it has also discussed the Zambian government policies and initiatives to promote deployment of solar energy technologies in the country. The review of solar photovoltaic energy is vital, as it will help the decision makers and various stakeholders to understand the current renewable status, barriers and challenges in Zambia and find alternative ways to overcome these challenges and barriers

Childbearing and family planning choices of women living with HIV and AIDS: the lived experiences

Objective: The main objective of this study was to assess the reproductive choices for Women Living with HIV on ART in the urban health centres within Lusaka.Methods: Nine hundred and fifty six HIV-positive women receiving care in the zoned health centres were randomly sampled and 12 health care workers who were purposefully sampled and were available in the ART setting participated in the study. A survey questionnaire, in-depth interviews and focus group discussions were the main data collection tools used. Quantitative data was analysed using SPSS while qualitative data was analysed using qualitative content analysis rooted in grounded theory (Precaution Adoption Model (PAPM).Results: The majority of the respondents in this study n = 503 (64%) felt that it was important to be safe from becoming pregnant whereas n = 429 (46%) felt that it was not. Health workers counselled the respondents on nearly all of the available contraceptive methods, with an emphasis on the oral pill, injectable hormonal drug, and on male and female condoms – with the greatest emphasis on the male condom. The reasons that women had for selecting particular family planning methods varied temporally. Some women engaged in unprotected sex because their partner was also HIV seropositive. Even in situations when an HIV-positive woman was told of her sero status and given counselling on the risks of motherto- child-transmission (MTCT), the majority of women would still engage in unprotected sex that often led to pregnancy. Nurses preferentially discouraged the women from getting pregnant using the counselling methods described. The rationale for the counselling methods was based on age, education, medical and gynaecological complications. In the current health care setup, it was not demonstrated that reproductive health issues of people living with HIV and AIDS could be provided within the ART clinic.Conclusion: As HIV continues to spread among women of childbearing age, there is an increasing need for support programs for infected women regarding sex, safer sex, pregnancy and family planning. The healthcare challenges for this group must be addressed with a twopronged approach- women must prioritize the risk to their health with repeated exposures to HIV and the healthcare workers must empower them to make these decisions. For this to occur, it is crucial that HIV positive women have easy access to reproductive healthcare counselling in juxtaposition to the ART Clinic. The health care workers that directly counsel these women have a pivotal role in addressing these concerns. Nursing professionals who comprise the bulk of healthcare workers providing these services can play a major role in meeting these needs

Attitudes of primary health care providers towards people with mental illness: evidence from two districts in Zambia

Written in conjunction with the Mental Health and Poverty Project Research Programme ConsortiumObjective: The aim of this study was to explore health care providers’ attitudes towards people with mental illness within two districts in Zambia. It sought to document types of attitudes of primary health care providers towards people suffering from mental illness and possible predictors of such attitudes. This study offers insights into how health care providers regard people with mental illness that may be helpful in designing appropriate training or re-training programs in Zambia and other low-income African countries. Method: Using a pilot tested structured questionnaire, data were collected from a total of 111 respondents from health facilities in the two purposively selected districts in Zambia that the Ministry of Health has earmarked as pilot districts for integrating mental health into primary health care. Results: There are widespread stigmatizing and discriminatory attitudes among primary health care providers toward mental illness and those who suffer from it. These findings confirm and add weight to the results from the few other studies which have been conducted in Africa that have challenged the notion that stigma and discrimination of mental illness is less severe in African countries. Conclusion: There is an urgent need to start developing more effective awareness-raising, training and education programmes amongst health care providers. This will only be possible if there is increased consensus, commitment and political will within government to place mental health on the national agenda and secure funding for the sector. These steps are essential if the country is improve the recognition, diagnosis and treatment of mental disorders, and realize the ideals enshrined in the progressive health reforms undertaken over the last decade.Key words: Mental health; Stigma; Discrimination; Primary health care giver

Validation of the UNC OCT Index for the Diagnosis of Early Glaucoma

Purpose:To independently validate the performance of the University of North Carolina Optical Coherence Tomography (UNC OCT) Index in diagnosing and predicting early glaucoma. Methods:Data of 118 normal subjects (118 eyes) and 96 subjects (96 eyes) with early glaucoma defined as visual field mean deviation (MD) greater than -4 decibels (dB), aged 40 to 80 years, and who were enrolled in the Full-Threshold Testing Size III, V, VI comparison study were used in this study. CIRRUS OCT average and quadrants' retinal nerve fiber layer (RNFL); optic disc vertical cup-to-disc ratio (VCDR), cup-to-disc area ratio, and rim area; and average, minimum, and six sectoral ganglion cell-inner plexiform layer (GCIPL) measurements were run through the UNC OCT Index algorithm. Area under the receiver operating characteristic curve (AUC) and sensitivities at 95% and 99% specificity were calculated and compared between single parameters and the UNC OCT Index. Results:Mean age was 60.1 ± 11.0 years for normal subjects and 66.5 ± 8.1 years for glaucoma patients (P < 0.001). MD was 0.29 ± 1.04 dB and -1.30 ± 1.35 dB in normal and glaucomatous eyes (P < 0.001), respectively. The AUC of the UNC OCT Index was 0.96. The best single metrics when compared to the UNC OCT Index were VCDR (0.93, P = 0.054), average RNFL (0.92, P = 0.014), and minimum GCIPL (0.91, P = 0.009). The sensitivities at 95% and 99% specificity were 85.4% and 76.0% (UNC OCT Index), 71.9% and 62.5% (VCDR, all P < 0.001), 64.6% and 53.1% (average RNFL, all P < 0.001), and 66.7% and 58.3% (minimum GCIPL, all P < 0.001), respectively. Conclusions:The findings confirm that the UNC OCT Index may provide improved diagnostic perforce over that of single OCT parameters and may be a good tool for detection of early glaucoma. Translational Relevance:The UNC OCT Index algorithm may be incorporated easily into routine clinical practice and be useful for detecting early glaucoma

Validation of the UNC OCT Index for the Diagnosis of Early Glaucoma

Observations of binary stars containing an accreting black hole or neutron star often show x-ray emission extending to high energies (>10 kilo­–electron volts), which is ascribed to an accretion disk corona of energetic particles akin to those seen in the solar corona. Despite their ubiquity, the physical conditions in accretion disk coronae remain poorly constrained. Using simultaneous infrared, optical, x-ray, and radio observations of the Galactic black hole system V404 Cygni, showing a rapid synchrotron cooling event in its 2015 outburst, we present a precise 461 ± 12 gauss magnetic field measurement in the corona. This measurement is substantially lower than previous estimates for such systems, providing constraints on physical models of accretion physics in black hole and neutron star binary systems

HIV-1 Effects on Neuropsychological Performance in a Resource-Limited Country, Zambia

Zambia has substantially been affected by the HIV/AIDS epidemic with prevalence rates at 14% in a population estimated at 12 million. Yet, the extent of HIV-associated neurocognitive disorders (HAND) in this population remains to be clearly understood. A series of culturally appropriate neuropsychological (NP) assessments [International HIV Dementia Scale (IHDS), Color Trails Test 1 and 2, Grooved pegboard Test, and Time Gait Test] were used to test the effects of HIV on NP performance of HIV seropositive and seronegative individuals. Twenty-two percent HIV positive individuals ARV naïve met the criteria for IHDS-defined NP impairment. Gender significantly influenced the performance on NP tests with females performing more poorly compared to males. Larger studies that will accommodate gender differences and age are necessary to generate appropriate norms in Zambia in order to better assess the prevalence of HAND in the developing country setting

Mental illness - stigma and discrimination in Zambia

Objective: The aim of this qualitative study was to explore the presence, causes and means of addressing individual and systemic stigma and discrimination against people with mental illness in Zambia. This is to facilitate the development of tailor-made antistigma initiatives that are culturally sensitive for Zambia and other low-income African countries. This is the first in-depth study on mental illness stigma in Zambia. Method: Fifty semi-structured interviews and 6 focus group discussions were conducted with key stakeholders drawn from 3 districts in Zambia (Lusaka, Kabwe and Sinazongwe). Transcripts were analyzed using a grounded theory approach. Results: Mental illness stigma and discrimination is pervasive across Zambian society, prevailing within the general community, amongst family members, amid general and mental health care providers, and at the level of government. Such stigma appears to be fuelled by misunderstandings of mental illness aetiology; fears of contagion and the perceived dangerousness of people with mental illness; and associations between HIV/AIDS and mental illness. Strategies suggested for reducing stigma and discrimination in Zambia included education campaigns, the transformation of mental health policy and legislation and expanding the social and economic opportunities of the mentally ill. Conclusion: In Zambia, as in many other lowincome African countries, very little attention is devoted to addressing the negative beliefs and behaviours surrounding mental illness, despite the devastating costs that ensue. The results from this study underscore the need for greater commitment from governments and policy-makers in African countries to start prioritizing mental illness stigma as a major public health and development issue

Physical activity and dietary behaviour in a population-based sample of British 10-year old children: the SPEEDY study (Sport, Physical activity and Eating behaviour: environmental Determinants in Young people).

BACKGROUND: The SPEEDY study was set up to quantify levels of physical activity (PA) and dietary habits and the association with potential correlates in 9-10 year old British school children. We present here the analyses of the PA, dietary and anthropometry data. METHODS: In a cross-sectional study of 2064 children (926 boys, 1138 girls) in Norfolk, England, we collected anthropometry data at school using standardised procedures. Body mass index (BMI) was used to define obesity status. PA was assessed with the Actigraph accelerometer over 7 days. A cut-off of > or = 2000 activity counts was used to define minutes of moderate-to-vigorous PA (MVPA). Dietary habits were assessed using the Health Behaviour in School Children food questionnaire. Weight status was defined using published international cut-offs (Cole, 2000). Differences between groups were assessed using independent t-tests for continuous data and chi-squared tests for categorical data. RESULTS: Valid PA data (>500 minutes per day on > or = 3 days) was available for 1888 children. Mean (+/- SD) activity counts per minute among boys and girls were 716.5 +/- 220.2 and 635.6 +/- 210.6, respectively (p < 0.001). Boys spent an average of 84.1 +/- 25.9 minutes in MVPA per day compared to 66.1 +/- 20.8 among girls (p < 0.001), with an average of 69.1% of children accumulating 60 minutes each day. The proportion of children classified as overweight and obese was 15.0% and 4.1% for boys and 19.3% and 6.6% for girls, respectively (p = 0.001). Daily consumption of at least one portion of fruit and of vegetables was 56.8% and 49.9% respectively, with higher daily consumption in girls than boys and in children from higher socioeconomic backgrounds. CONCLUSION: Results indicate that almost 70% of children meet national PA guidelines, indicating that a prevention of decline, rather than increasing physical activity levels, might be an appropriate intervention target. Promotion of daily fruit and vegetable intake in this age group is also warranted, possibly focussing on children from lower socioeconomic backgrounds.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are