Mashing with unmalted sorghum using a novel low temperature enzyme system: impacts of sorghum grain composition and microstructure

Brewing lager beers from unmalted sorghum traditionally requires the use of high temperature mashing and exogenous enzymes to ensure adequate starch conversion. Here, a novel low-temperature mashing system is compared to a more traditional mash in terms of the wort quality produced (laboratory scale) from five unmalted sorghums (2 brewing and 3 non-brewing varieties). The low temperature mash generated worts of comparable quality to those resulting from a traditional energy intensive mash protocol. Furthermore, its performance was less dependent on sorghum raw material quality, such that it may facilitate the use of what were previously considered non-brewing varieties. Whilst brewing sorghums were of lower protein content, protein per se did not correlate with mashing performance. Rather, it was the way in which protein was structured (particularly the strength of protein starch interactions) which most influenced brewing performance. RVA profile was the easiest way of identifying this characteristic as potentially problematic

The Maltase Involved in Starch Metabolism in Barley Endosperm Is Encoded by a Single Gene

During germination and early seedling growth of barley (Hordeum vulgare), maltase is responsible for the conversion of maltose produced by starch degradation in the endosperm to glucose for seedling growth. Despite the potential relevance of this enzyme for malting and the production of alcoholic beverages, neither the nature nor the role of maltase is fully understood. Although only one gene encoding maltase has been identified with certainty, there is evidence for the existence of other genes and for multiple forms of the enzyme. It has been proposed that maltase may be involved directly in starch granule degradation as well as in maltose hydrolysis. The aim of our work was to discover the nature of maltase in barley endosperm. We used ion exchange chromatography to fractionate maltase activity from endosperm of young seedlings, and we partially purified activity for protein identification. We compared maltase activity in wild-type barley and transgenic lines with reduced expression of the previously-characterised maltase gene Agl97, and we used genomic and transcriptomic information to search for further maltase genes. We show that all of the maltase activity in the barley endosperm can be accounted for by a single gene, Agl97. Multiple forms of the enzyme most likely arise from proteolysis and other post-translational modifications

An approach to developing a prediction model of fertility intent among HIV-positive women and men in Cape Town, South Africa: a case study

As a ‘case-study’ to demonstrate an approach to establishing a fertility-intent prediction model, we used data collected from recently diagnosed HIV-positive women (N = 69) and men (N = 55) who reported inconsistent condom use and were enrolled in a sexual and reproductive health intervention in public sector HIV care clinics in Cape Town, South Africa. Three theoretically-driven prediction models showed reasonable sensitivity (0.70–1.00), specificity (0.66–0.94), and area under the receiver operating characteristic curve (0.79–0.89) for predicting fertility intent at the 6-month visit. A k-fold cross-validation approach was employed to reduce bias due to over-fitting of data in estimating sensitivity, specificity, and area under the curve. We discuss how the methods presented might be used in future studies to develop a clinical screening tool to identify HIV-positive individuals likely to have future fertility intent and who could therefore benefit from sexual and reproductive health counselling around fertility options

Factors Influencing Pregnancy Desires among HIV Positive Women in Sibande District in Mpumalanga, South Africa.

Fertility issues for HIV-positive women are becoming increasingly important. The study investigated the pregnancy desires of HIV positive women of Gert Sibande District in Mpumalanga, South Africa. The objective of the study is to present findings on factors influencing pregnancy desires amongst HIV positive women that have participated in Prevention of Mother to child Transmission of HIV programme. A cross sectional survey was conducted. 47 public health facilities in Gert Sibande District of Mpumalanga, South Africa were used to conduct interviews between September 2008 and March 2009. 815 HIV infected mothers at postnatal care, with babies aged 3-6 months. Women in the current study had poor knowledge about HIV transmission from mother to child. We found that only 16.6% had a desire to have children. In multivariable regression analysis the desire to have children was associated with having fewer children, had discussed family planning, current partner knew his HIV status and unknown HIV status of their infant. The main family methods currently used was injection (54.8%), followed by condom (33.9%), the pill (22%) and female condom (14.6%). Women with HIV who desire to have children face risks that need special consideration. Family planning for HIV infected women should be promoted and improved in postnatal care.Key words: Prevention of Mother to child Transmission of HIV programme (PMTCT), pregnancy desires, family planning, male involvement, HIV knowledge, HIV positive mothers

Pre- and post-intervention assessment of a PMTCT-programme-strenghtening initiative in a rural area of the Eastern Cape, South Africa

The research assesses prevention-of-mother-to-child-transmission-of-HIV (PMTCT) services following implementation of programme-strengthening activities in a municipality in the Eastern Cape Province, South Africa. A pre-intervention and post-intervention design was used to conduct facility assessments and client exit interviews at baseline and after 28 months. For the facility assessments, unstructured interviews were conducted with the heads of maternity wards at each delivery facility (n = 4), nurses (n = 9) and lay counsellors (n = 18). District Health Information System (DHIS) records were used to assess changes on PMTCT-programme indicators. Observations were conducted at the fixed clinics and hospitals to determine compliance to the national criteria for PMTCT-services delivery. For the exit interviews with clients, the pre- and post-assessment samples, respectively, included women attending for antenatal care (n = 296; n = 239) as well as HIV-positive women attending for postnatal care (n = 70; n = 142). The personnel generally perceived the PMTCT services as having been strengthened as a result of the initiative and the DHIS records showed positive changes. Client exit interviews revealed significant increases in the numbers of women who: were aware of the PMTCT programme; were tested for HIV during their pregnancy; were aware of VCT before coming to the facility; knew their HIV-test result; and, had helpful pre-HIV-test and/or post-HIV-test counselling experiences. The long waiting periods at the facilities and the relatively short length of the counselling sessions remained a serious concern. Lessons learnt may help with designing strategies to expand the national programme in South Africa as well as PMTCT programmes elsewhere.

Pre-post assessment of PMTCT in Kouga LSA

Paper presented at the SAHARA Conference, Johannesburg, 30 November to 3 Decembe

Implementing a rural programme of Prevention of Mother-to-Child Transmission of HIV in Kouga LSA, South Africa: a pre-post evaluation: final report: Kouga LSA PMTCT programme implementation

Commissioned by the Eastern Cape Department of Health Management, AugustBaseline assessment of missed opportunities for PMTCT was conducted in the Kouga LSA in 2007 to gather information on the status of PMTCT programme implementation prior to initiating programme strengthening activities. Identified gaps in the PMTCT programme were staff shortage, lack of guidelines, stock outs, no monitoring and evaluation system, lack of training and poor data collection methods. Interventions included provision of guidelines and policies, monitoring and evaluation by development of operational plans, establishing support group facilitators, training of staff (lay counsellors and nurses on VCT/PMTCT, M&E and dual therapy) and appointment of staff (professional and enrolled nurses, and a data capturer). After these interventions, a post-assessment was conducted in 2009 in the same health facilities using same methods employed during baseline assessment in order to determine whether there were any improvements brought about by the programme strengthening activities. This report presents the pre-post assessment results

Programme to improve implementation of the Prevention of Mother to Child Transmission of HIV in Gert Sibande district in Mpumalanga, South Africa: baseline report: Gert Sibande PMTCT programme implementation

SeptemberBackground: A baseline assessment of the PMTCT programme was conducted in the Gert Sibande district of Mpumalanga province in 2008-9 to gather information on the status of PMTCT programme implementation at all Gert Sibande health facilities prior to initiating programme strengthening activities. Identified gaps in the PMTCT programme were staff shortage, lack of guidelines, stock outs, no monitoring and evaluation system, lack of training and poor data collection methods. Interventions to address identified gaps are currently in progress. This report presents the baseline assessment results. The assessment comprised * Facility and * Client assessments Methods: A baseline rapid assessment was conducted by trained researchers in the formal health sector with pregnant mothers and mothers with infants between 3 months and 8 months of age. (a) Interventions to strengthen PMTCT programme implementation (b) Monitoring and evaluation support. Key findings Facility assessments Few facilities had all the required national guidelines/protocols/policies on HIV management. More than half of facilities did not have all provincial guidelines/protocols/policies. 48 out of 75 facilities had the updated PMTCT guideline. Facilities generally had IEC materials. Seventy out of 75 facilities conducted on-site HIV testing and 68 had VCT services daily. Refusals on HIV testing by clients was reported by 62 facilities. Reasons stated by clients for refusal of testing were: * fear of the outcome, * client not ready for results, * client scared of the test and * some needed time to think. Refusal of testing needs further investigation as the case registers does not distinguish clients who were tested during the previous pregnancy from new clients. Therefore, some clients might have refused because they have been tested before. All facilities had at least one PN responsible for HIV testing, except in Lekwa and Albert Luthuli. The need for training of staff on PMTCT/VCT was high in all sub-districts. Staff needed training on dual therapy. Most facilities generally had at least two lay counsellors, with a few exceptions, but there was no work schedule for lay counsellors. Lack of space made it difficult for some facilities to have a counselling room. More than half of facilities promoted family planning during VCT. Several facilities did not do PCR testing on site, and they did not have PCR testing kits. Shortage of infant formula was reported by 64 facilities. A significant number of facilities did not have a follow-up system for infants born to HIV-positive mothers. Programme managers expressed concerns about staff shortage, untrained staff, space problem and lack of supervision. Women who opted to deliver their babies at home posed a challenge to health care facilities. Another challenge was women knew their HIV status did not disclose to their families. As a result of not disclosing, they mixed fed their infants. Clients manipulated ANC coding cards and some were reluctant to take the prophylaxis drug. A large number of PNs reported a need for community awareness on PMTCT issues. M & E With regards to the recording of client data on case registers, a number of concerns were observed. Data were recorded on loose A3 sheets that may be misplaced. Data recorded on case registers differed from that recorded on monthly summary sheets and DHIS data. Data elements recorded in case registers did not tally with those on DHIS. More elements were recorded in case registers. However, there were facilities that had good data recording as evidenced by concordant records in case registers, monthly summary sheets and DHIS. Poor data recording was attributed to staff shortage and heavy workload of PNs. HIV knowledge and attitude A high percentage of women were aware that HIV could be transmitted during pregnancy, delivery and through breast feeding. Disclosure of the HIV status was a challenge as 285 had not discussed their status with their partners. A concern that was reported by clients was ARV shortage at facilities. Some clients indicated that they were not given after testing for HIV. Lay counsellors proved to be valuable members of the health team as more clients received their HIV test results from lay counsellors than nurses. Conclusion and recommendations: Findings of the rapid assessment reveal a need to strengthen PMTCT service delivery at Gert Sibande. Staff shortage compromises service delivery and the quality of service as the PNs are overwhelmed with a heavy workload. Bound case registers or electronic data recording would ease the problem of tallying data at the end of the month. The number of PNs needs to be increased as some facilities served a large population. A follow-up system for infants born to HIV mothers is crucial. Shortages of infant formula might lead to mixed feeding. Poor data might contribute to under stocking of infant formula. All clients who have been tested should receive their test results