EDUCATORS’ PERSPECTIVES ABOUT ICT ENABLED TEACHING

The availability of Information and Communication Technologies (ICT) in education has not translated to pedagogical use in Higher Education Institutions (HEI), particularly in the developing nations context where use of ICT based paradigms like e-learning is invisible. This study investigated the educators’ perspectives about ICT enabled teaching strategies by employing quantitative and qualitative data collection instruments. Findings revealed that despite valuing these strategies, educators have institutional and technological concerns requiring redress. Contrary to existing literature, generation gap, ICT literacy and individual values had no effect to the way the cohort perceives ICT based teaching. Instead, university’s’ structures, management decision making and the ICT implementation culture were major themes emerging from this study, as the source of the sporadic ICT utilization that translates to the second order digital divide, a problem of concern both in theory and practice.&nbsp

Dolutegravir twice-daily dosing in children with HIV-associated tuberculosis: a pharmacokinetic and safety study within the open-label, multicentre, randomised, non-inferiority ODYSSEY trial

Background: Children with HIV-associated tuberculosis (TB) have few antiretroviral therapy (ART) options. We aimed to evaluate the safety and pharmacokinetics of dolutegravir twice-daily dosing in children receiving rifampicin for HIV-associated TB. Methods: We nested a two-period, fixed-order pharmacokinetic substudy within the open-label, multicentre, randomised, controlled, non-inferiority ODYSSEY trial at research centres in South Africa, Uganda, and Zimbabwe. Children (aged 4 weeks to <18 years) with HIV-associated TB who were receiving rifampicin and twice-daily dolutegravir were eligible for inclusion. We did a 12-h pharmacokinetic profile on rifampicin and twice-daily dolutegravir and a 24-h profile on once-daily dolutegravir. Geometric mean ratios for trough plasma concentration (Ctrough), area under the plasma concentration time curve from 0 h to 24 h after dosing (AUC0–24 h), and maximum plasma concentration (Cmax) were used to compare dolutegravir concentrations between substudy days. We assessed rifampicin Cmax on the first substudy day. All children within ODYSSEY with HIV-associated TB who received rifampicin and twice-daily dolutegravir were included in the safety analysis. We described adverse events reported from starting twice-daily dolutegravir to 30 days after returning to once-daily dolutegravir. This trial is registered with ClinicalTrials.gov (NCT02259127), EudraCT (2014–002632-14), and the ISRCTN registry (ISRCTN91737921). Findings: Between Sept 20, 2016, and June 28, 2021, 37 children with HIV-associated TB (median age 11·9 years [range 0·4–17·6], 19 [51%] were female and 18 [49%] were male, 36 [97%] in Africa and one [3%] in Thailand) received rifampicin with twice-daily dolutegravir and were included in the safety analysis. 20 (54%) of 37 children enrolled in the pharmacokinetic substudy, 14 of whom contributed at least one evaluable pharmacokinetic curve for dolutegravir, including 12 who had within-participant comparisons. Geometric mean ratios for rifampicin and twice-daily dolutegravir versus once-daily dolutegravir were 1·51 (90% CI 1·08–2·11) for Ctrough, 1·23 (0·99–1·53) for AUC0–24 h, and 0·94 (0·76–1·16) for Cmax. Individual dolutegravir Ctrough concentrations were higher than the 90% effective concentration (ie, 0·32 mg/L) in all children receiving rifampicin and twice-daily dolutegravir. Of 18 children with evaluable rifampicin concentrations, 15 (83%) had a Cmax of less than the optimal target concentration of 8 mg/L. Rifampicin geometric mean Cmax was 5·1 mg/L (coefficient of variation 71%). During a median follow-up of 31 weeks (IQR 30–40), 15 grade 3 or higher adverse events occurred among 11 (30%) of 37 children, ten serious adverse events occurred among eight (22%) children, including two deaths (one tuberculosis-related death, one death due to traumatic injury); no adverse events, including deaths, were considered related to dolutegravir. Interpretation: Twice-daily dolutegravir was shown to be safe and sufficient to overcome the rifampicin enzyme-inducing effect in children, and could provide a practical ART option for children with HIV-associated TB

Neuropsychiatric manifestations and sleep disturbances with dolutegravir-based antiretroviral therapy versus standard of care in children and adolescents: a secondary analysis of the ODYSSEY trial

BACKGROUND: Cohort studies in adults with HIV showed that dolutegravir was associated with neuropsychiatric adverse events and sleep problems, yet data are scarce in children and adolescents. We aimed to evaluate neuropsychiatric manifestations in children and adolescents treated with dolutegravir-based treatment versus alternative antiretroviral therapy. METHODS: This is a secondary analysis of ODYSSEY, an open-label, multicentre, randomised, non-inferiority trial, in which adolescents and children initiating first-line or second-line antiretroviral therapy were randomly assigned 1:1 to dolutegravir-based treatment or standard-of-care treatment. We assessed neuropsychiatric adverse events (reported by clinicians) and responses to the mood and sleep questionnaires (reported by the participant or their carer) in both groups. We compared the proportions of patients with neuropsychiatric adverse events (neurological, psychiatric, and total), time to first neuropsychiatric adverse event, and participant-reported responses to questionnaires capturing issues with mood, suicidal thoughts, and sleep problems. FINDINGS: Between Sept 20, 2016, and June 22, 2018, 707 participants were enrolled, of whom 345 (49%) were female and 362 (51%) were male, and 623 (88%) were Black-African. Of 707 participants, 350 (50%) were randomly assigned to dolutegravir-based antiretroviral therapy and 357 (50%) to non-dolutegravir-based standard-of-care. 311 (44%) of 707 participants started first-line antiretroviral therapy (ODYSSEY-A; 145 [92%] of 157 participants had efavirenz-based therapy in the standard-of-care group), and 396 (56%) of 707 started second-line therapy (ODYSSEY-B; 195 [98%] of 200 had protease inhibitor-based therapy in the standard-of-care group). During follow-up (median 142 weeks, IQR 124–159), 23 participants had 31 neuropsychiatric adverse events (15 in the dolutegravir group and eight in the standard-of-care group; difference in proportion of participants with ≥1 event p=0·13). 11 participants had one or more neurological events (six and five; p=0·74) and 14 participants had one or more psychiatric events (ten and four; p=0·097). Among 14 participants with psychiatric events, eight participants in the dolutegravir group and four in standard-of-care group had suicidal ideation or behaviour. More participants in the dolutegravir group than the standard-of-care group reported symptoms of self-harm (eight vs one; p=0·025), life not worth living (17 vs five; p=0·0091), or suicidal thoughts (13 vs none; p=0·0006) at one or more follow-up visits. Most reports were transient. There were no differences by treatment group in low mood or feeling sad, problems concentrating, feeling worried or feeling angry or aggressive, sleep problems, or sleep quality. INTERPRETATION: The numbers of neuropsychiatric adverse events and reported neuropsychiatric symptoms were low. However, numerically more participants had psychiatric events and reported suicidality ideation in the dolutegravir group than the standard-of-care group. These differences should be interpreted with caution in an open-label trial. Clinicians and policy makers should consider including suicidality screening of children or adolescents receiving dolutegravir

A paradox of the second order digital divide in higher education institutions of developing countries: case of Zimbabwe

Although this is not a new research phenomenon, the literature has often associated the digital divide (second order or otherwise) with sociodemographic, sociocultural and socioeconomical factors as reasons for the digital divide. However, there is little presence in the literature into the underlying structures (physical or abstract arrangement) leading to the divide. This means that the underlying structures leading to this problem have so far been ignored and require scholarly attention. This study, therefore, identifies and explains the structures leading to the second order digital divide, a problem relating to the unequal use of information and communication technologies (ICTs) which is more prevalent in the higher education institutions (HEIs) of developing countries. Before the structures that lead to the second order digital divide could be explained the interlocking dynamics of ICT adoption needed to be identified. Structuration Theory was employed as a sensitising tool for collecting, analysing, and interpreting qualitative data for this interpretivist research. Novel qualitative data were collected from a purposive sample drawn from a single HEI of Zimbabwe, a developing country of high literacy. Directed content analysis generated insightful explanations of the structures leading to the second order digital divide at the HEI case. Preliminary analysis based on a deductive logic approach identified signification, domination, and legitimation as some of the structures leading to the second order digital divide at the HEI case. Further analysis based on an inductive logic approach revealed additional belief, institutional and governance structures which manifested from the interlocking dynamics of ICT adoption, involving resources, leadership, adoption behaviours and empowerment. These findings contributed to practice by explaining the underlying structures of the second order digital divide, for the benefit of ICT4D researchers, and by suggesting interventions to HEI policy-makers for reducing the second order digital divide. The results also make an iv explanatory contribution to theory by presenting a model of the interlocking dynamics of ICT adoption for theorising about the complex second order digital divide

Non-optionality at Zulu L2 first syntax

The Valueless Features Hypothesis of Eubank (1993/94; 1994; 1996) proposes that certain types of apparently optional syntactic processes that appear in initial and not in mature state grammars are due to a lack of specification of inflectional feature values at the initial state of grammatical knowledge. Thus the apparent optionality in the placement of medial adverbs vis-a-vis thematic or finite main verbs evident in the early stages of second language (L2) acquisition is attributed to non-transfer of the strength values of morphological features instantiated in the learners' first language (LJ). This paper provides experimental evidence from Zulu L2 acquisition of verb raising by English native speakers, which suggests non-optionality in the early developmental stages of L2 syntax. The paper suggests that the initial obligaloriness of a non-verb raising syntactic analysis evident in the early stages of Zulu L2 acquisition is LJ -based; indicating transfer of [- strong] Vfeatures in T instantiated in English. Die 'Valueless Features Hypothesis' van Eubank' (1993/94; 1994; 1996) stel voor dat sekere tipes skynbare opsionele sintaktiese prosesse wat by aanvanklike grammatikas voorkom, maar nie by grammatikas in 'n gevorderde stadium nie, die gevolg is van 'n gebrek aan spesifikasie van infleksionele kenmerkwaardes tydens die aanvanklike stadium van grammatikale kennis. Derhalwe word die skynbare opsionaliteit in die plasing van tussenbywoorde teenoor tematiese of hoofwerkwoorde in 'npersoonsvorm wat by die vroee stadiums van die aankweek van 'n tweede taal (L2) duidelik blyk, toegeskryf aan die nie-oordrag van die kragwaardes van morfologiese kenmerke wat in die leerder se eerste taal (LJ) geinstansieer is. Hierdie skripsie lewer eksperimentele bewyse van werkwoordverheffing by die aanleer van Zulu (L2) deur aangebore Engelssprekendes, wat nie-opsionaliteit in die vroee ontwikkelingstadia van L2- sinsleer suggereer. Die skripsie stel voor dat die aanvanklike verpligting van 'n niewerkwoordverhejJende sintaktiese ontleding, wat in die vroee stadium by die aanleer van Zulu L2 voorkom, L1-gebaseer is; wat dui op 'n oordrag van [- sterk} V-kenmerke in T wat in Engels geinstansieer is