Correlation between different PBL assessment components and the final mark for MB ChB III at a rural South African university

Background. Problem-based learning (PBL) is now an accepted component of many medical school programmes worldwide. Our university also follows the PBL ‘SPICES’ model for MB ChB III. The assessment modalities used are the modified essay questions (MEQ), objective structured practical examination (OSPE), individualised process assessment (IPA) and tutorial continuous assessment (TUT). This study was done to compare the students’ performances in individual assessment components with the final mark to determine the correlation between these parameters. Materials and methods. The study was retrospective, descriptive and analytical, based on the integrated marks of all the MB ChB III students at Walter Sisulu University (WSU) in 2007. Assessment marks were stratified according to blocks and different types of assessment (MEQ, TUT, OSPE, IPA). Regression analysis was used to compute and scrutinise these vis-à-vis their correspondence with the final marks for each block. Results. Three hundred and seventy-nine block assessment marks of 96 students from 4 blocks of MB ChB III were analysed and the correlation between the assessment components and final mark were compared. Regression analysis showed good correlation when analysing the assessment modality versus the final mark for the MEQs (r=0.93, 0.93, 0.94, 0.96), followed by OSPEs (r=0.71, 0.70, 0.76, 0.77) and IPAs (r=0.62, 0.51, 0.68, 0.77). However, correlation was not significant with the TUT. Conclusion. There was good correlation between the students’ performance in the majority of assessment modalities and the final mark in the different blocks of the MB ChB III examination. There may be a need to make tutorial assessment methods more objective, partly by additional tutor training

Performance-based financing contributes to the resilience of health services affected by the Liberian Ebola outbreak.

Setting: The Liberian counties of Bong, with performance-based financing (PBF) for all 36 public primary-care facilities, and Margibi, with no PBF for its 24 public primary-care facilities. Objective: To compare whether specific maternal and child health indicators changed in the two counties during the pre-Ebola (2013), Ebola (2014) and post-Ebola (2015) disease outbreak periods from July to September each year. Design: This was a cross-sectional study. Results: For pregnant women, the numbers of antenatal visits, intermittent preventive malaria treatments, human immunodeficiency virus (HIV) tests and facility-based births with skilled attendants all fell during the Ebola period, with decreases being significantly more marked in Margibi County. Apart from HIV testing, which remained low in both counties, these indicators increased in the post-Ebola period, with increases significantly more marked in Bong than in Margibi. The number of childhood immunisations decreased significantly in Bong in the Ebola period compared with the pre-Ebola period, but increased to above pre-Ebola levels in the post-Ebola period. There were markedly larger decreases in childhood immunisations in Margibi County during the Ebola period, which remained significantly lower in the post-Ebola period compared with Bong County. Conclusion: In a PBF-supported county, selected maternal and childhood health indicators showed less deterioration during Ebola and better recovery post-Ebola than in a non-PBF-supported county

Knowledge, attitudes and behaviours of adolescents in relation to STIs, pregnancy, contraceptive utilization and substance abuse in the Mhlakulo region, Eastern Cape

Background: Sexually transmitted infections (STIs) and HIV/AIDS are a major problem in South Africa. This, coupled with a high incidence of teenage pregnancy, alcohol and drug abuse, is of grave concern, especially its impact among the young (15–24 years) and in economically poor, rural populations. This study aimed to assess the youths’ knowledge, attitudes and behaviours regarding STIs, teenage pregnancy, contraception and substance abuse.Methodology: This is an interview-based, descriptive study. The sample design employed a stratified sample (using schools as strata) of young people aged 15 to 24 years in three schools in the Mhlakulo region, Eastern Cape province. From each school, a sample of learners from grades 10 to 12 was selected randomly. Questionnaires covering relevantparameters were used to interview the learners, after which the data were assimilated and analysed.Results: A total of 150 learners were surveyed (86 females and 64 males). In total, 56% of them knew about STIs. About 88% of the participants learned about STIs from health care workers/nurses/doctors/clinics, the media, educators, the school and friends. Most preferred to communicate to friends (38.67%) and siblings (28%); only 15% communicated with parents. Among the sexually active, 54% reported the use of condoms; of these only 62% used them consistently. Of the participants, 7.33% had more than five sexual partners. Of the young women, 12.8% reported to have fallen pregnant with one-sixth of them wanting to become pregnant. Thirty per cent of those pregnant had to quit school, but did return subsequently. Common contraceptives used were condoms (54%) and pills (58%). Twenty-two per cent of the youths admitted to the use of recreational drugs at some time; most of these were related to alcohol (19.33%). A small fraction (1.33%) used dagga (cannabis).Conclusion: There is lack of knowledge of STIs and their prevention and condom and contraceptive use among young people of this community. Sexual promiscuity and teenage pregnancy in the group is a cause for concern. Substance abuse is another important problem that requires urgent attention.Keywords: STIs (sexually transmitted infections); youth; teenage pregnancy; contraception; substance abus

HIV Prevention in Care and Treatment Settings: Baseline Risk Behaviors among HIV Patients in Kenya, Namibia, and Tanzania.

HIV care and treatment settings provide an opportunity to reach people living with HIV/AIDS (PLHIV) with prevention messages and services. Population-based surveys in sub-Saharan Africa have identified HIV risk behaviors among PLHIV, yet data are limited regarding HIV risk behaviors of PLHIV in clinical care. This paper describes the baseline sociodemographic, HIV transmission risk behaviors, and clinical data of a study evaluating an HIV prevention intervention package for HIV care and treatment clinics in Africa. The study was a longitudinal group-randomized trial in 9 intervention clinics and 9 comparison clinics in Kenya, Namibia, and Tanzania (N = 3538). Baseline participants were mostly female, married, had less than a primary education, and were relatively recently diagnosed with HIV. Fifty-two percent of participants had a partner of negative or unknown status, 24% were not using condoms consistently, and 11% reported STI symptoms in the last 6 months. There were differences in demographic and HIV transmission risk variables by country, indicating the need to consider local context in designing studies and using caution when generalizing findings across African countries. Baseline data from this study indicate that participants were often engaging in HIV transmission risk behaviors, which supports the need for prevention with PLHIV (PwP). TRIAL REGISTRATION: ClinicalTrials.gov NCT01256463

A systematic review of population health interventions and Scheduled Tribes in India

<p>Abstract</p> <p>Background</p> <p>Despite India's recent economic growth, health and human development indicators of Scheduled Tribes (ST) or <it>Adivasi </it>(India's indigenous populations) lag behind national averages. The aim of this review was to identify the public health interventions or components of these interventions that are effective in reducing morbidity or mortality rates and reducing risks of ill health among ST populations in India, in order to inform policy and to identify important research gaps.</p> <p>Methods</p> <p>We systematically searched and assessed peer-reviewed literature on evaluations or intervention studies of a population health intervention undertaken with an ST population or in a tribal area, with a population health outcome(s), and involving primary data collection.</p> <p>Results</p> <p>The evidence compiled in this review revealed three issues that promote effective public health interventions with STs: (1) to develop and implement interventions that are low-cost, give rapid results and can be easily administered, (2): a multi-pronged approach, and (3): involve ST populations in the intervention.</p> <p>Conclusion</p> <p>While there is a growing body of knowledge on the health needs of STs, there is a paucity of data on how we can address these needs. We provide suggestions on how to undertake future population health intervention research with ST populations and offer priority research avenues that will help to address our knowledge gap in this area.</p

Cooperation of Sumoylated Chromosomal Proteins in rDNA Maintenance

SUMO is a posttranslational modifier that can modulate protein activities, interactions, and localizations. As the GFP-Smt3p fusion protein has a preference for subnucleolar localization, especially when deconjugation is impaired, the nucleolar role of SUMO can be the key to its biological functions. Using conditional triple SUMO E3 mutants, we show that defects in sumoylation impair rDNA maintenance, i.e., the rDNA segregation is defective and the rDNA copy number decreases in these mutants. Upon characterization of sumoylated proteins involved in rDNA maintenance, we established that Top1p and Top2p, which are sumoylated by Siz1p/Siz2p, most likely collaborate with substrates of Mms21p to maintain rDNA integrity. Cohesin and condensin subunits, which both play important roles in rDNA stability and structures, are potential substrates of Mms21, as their sumoylation depends on Mms21p, but not Siz1p and Siz2p. In addition, binding of cohesin and condensin to rDNA is altered in the mms21-CH E3-deficient mutant

Single-feature polymorphism discovery by computing probe affinity shape powers

<p>Abstract</p> <p>Background</p> <p>Single-feature polymorphism (SFP) discovery is a rapid and cost-effective approach to identify DNA polymorphisms. However, high false positive rates and/or low sensitivity are prevalent in previously described SFP detection methods. This work presents a new computing method for SFP discovery.</p> <p>Results</p> <p>The probe affinity differences and affinity shape powers formed by the neighboring probes in each probe set were computed into SFP weight scores. This method was validated by known sequence information and was comprehensively compared with previously-reported methods using the same datasets. A web application using this algorithm has been implemented for SFP detection. Using this method, we identified 364 SFPs in a barley near-isogenic line pair carrying either the wild type or the mutant <it>uniculm2 </it>(<it>cul2</it>) allele. Most of the SFP polymorphisms were identified on chromosome 6H in the vicinity of the <it>Cul2 </it>locus.</p> <p>Conclusion</p> <p>This SFP discovery method exhibits better performance in specificity and sensitivity over previously-reported methods. It can be used for other organisms for which GeneChip technology is available. The web-based tool will facilitate SFP discovery. The 364 SFPs discovered in a barley near-isogenic line pair provide a set of genetic markers for fine mapping and future map-based cloning of the <it>Cul2 </it>locus.</p