Seroprevalence of SARS-CoV-2 antibody among individuals aged above 15 years and residing in congregate settings in Dire Dawa city administration, Ethiopia

Background Determining the extent of seropositivity of SARS-CoV-2 antibody has the potential to guide prevention and control efforts. We aimed to determine the seroprevalence of SARS-CoV-2 antibody among individuals aged above15 years and residing in the congregate settings of Dire Dawa city administration, Ethiopia. Method We analyzed COVID-19 seroprevalence data on 684 individuals from a community based cross-sectional survey conducted among individuals aged above 15 years and residing in congregate settings in Dire Dawa from June 15 to July 30, 2020. Data were collected using interview and blood sample collection. Participants were asked about demographic characteristics, COVID-19 symptoms, and their practice of preventive measures. Seroprevalence was determined using SARS-CoV-2 IgG test. Bivariate and multivariate multilevel mixed effects logistic regression model was fitted and statistical significance was set at p value < 0.05. Result The estimated SARS-CoV-2 seroprevalence was 3.2% (95 % CI 2.0–4.8) in the study region with no differences by age and sex but considerable differences were observed by self-reported practice of COVID-19 preventive measures. The cluster effect is not significant (P = 0.396) which has suggested no evidence of heterogeneity in SARS-CoV-2 seroprevalence among the clusters. The odds of SARS-CoV-2 antibody seroprevalence were higher for individuals who were employed and work by moving from home to work area (AOR; 9.73 95% CI 2.51, 37.68), reported of not wearing facemasks when leaving home (AOR; 6.4 95% CI 2.30, 17.66) and did not practice physical distancing measures (AOR; 10 95% CI 3.01, 33.20) compared to their counterparts, respectively. Our estimated seroprevalence of SARS-CoV-2 among participants who reported not to have practiced social distancing measures was 12.8 (95% CI, 7.0, 19) and 1.5 (95% CI, 0.5, 2.5) among those who reported of practicing them. More than 80% of study participants reported of implementing infection prevention measures (face masks and physical distancing recommendations). Conclusion The detected SARS-CoV-2 seroprevalence among the study participants was low at the time of the survey indicating higher proportion of population yet to be infected. COVID-19 preventive measures were associated with reduced seroprevalence and should be promoted to avoid transmission to the uninfected majority

Development of a portfolio of learning for postgraduate family medicine training in South Africa: a Delphi study

<p>Abstract</p> <p>Background</p> <p>Within the 52 health districts in South Africa, the family physician is seen as the clinical leader within a multi-professional district health team. Family physicians must be competent to meet 90% of the health needs of the communities in their districts. The eight university departments of Family Medicine have identified five unit standards, broken down into 85 training outcomes, for postgraduate training. The family medicine registrar must prove at the end of training that all the required training outcomes have been attained. District health managers must be assured that the family physician is competent to deliver the expected service. The Colleges of Medicine of South Africa (CMSA) require a portfolio to be submitted as part of the uniform assessment of all registrars applying to write the national fellowship examinations. This study aimed to achieve a consensus on the contents and principles of the first national portfolio for use in family medicine training in South Africa.</p> <p>Methods</p> <p>A workshop held at the WONCA Africa Regional Conference in 2009 explored the purpose and broad contents of the portfolio. The 85 training outcomes, ideas from the WONCA workshop, the literature, and existing portfolios in the various universities were used to develop a questionnaire that was tested for content validity by a panel of 31 experts in family medicine in South Africa, via the Delphi technique in four rounds. Eighty five content items (national learning outcomes) and 27 principles were tested. Consensus was defined as 70% agreement. For those items that the panel thought should be included, they were also asked how to provide evidence for the specific item in the portfolio, and how to assess that evidence.</p> <p>Results</p> <p>Consensus was reached on 61 of the 85 national learning outcomes. The panel recommended that 50 be assessed by the portfolio and 11 should not be. No consensus could be reached on the remaining 24 outcomes and these were also omitted from the portfolio. The panel recommended that various types of evidence be included in the portfolio. The panel supported 26 of the 27 principles, but could not reach consensus on whether the portfolio should reflect on the relationship between the supervisor and registrar.</p> <p>Conclusion</p> <p>A portfolio was developed and distributed to the eight departments of Family Medicine in South Africa, and the CMSA, to be further tested in implementation.</p

The national portfolio for postgraduate family medicine training in South Africa : a descriptive study of acceptability, educational impact, and usefulness for assessment

Background: Since 2007 a portfolio of learning has become a requirement for assessment of postgraduate family medicine training by the Colleges of Medicine of South Africa. A uniform portfolio of learning has been developed and content validity established among the eight postgraduate programmes. The aim of this study was to investigate the portfolio's acceptability, educational impact, and perceived usefulness for assessment of competence. Methods: Two structured questionnaires of 35 closed and open-ended questions were delivered to 53 family physician supervisors and 48 registrars who had used the portfolio. Categorical and nominal/ordinal data were analysed using simple descriptive statistics. The open-ended questions were analysed with ATLAS.ti software. Results: Half of registrars did not find the portfolio clear, practical or feasible. Workshops on portfolio use, learning, and supervision were supported, and brief dedicated time daily for reflection and writing. Most supervisors felt the portfolio reflected an accurate picture of learning, but just over half of registrars agreed. While the portfolio helped with reflection on learning, participants were less convinced about how it helped them plan further learning. Supervisors graded most rotations, suggesting understanding the summative aspect, while only 61% of registrars reflected on rotations, suggesting the formative aspects are not yet optimally utilised. Poor feedback, the need for protected academic time, and pressure of service delivery impacting negatively on learning. Conclusion: This first introduction of a national portfolio for postgraduate training in family medicine in South Africa faces challenges similar to those in other countries. Acceptability of the portfolio relates to a clear purpose and guide, flexible format with tools available in the workplace, and appreciating the changing educational environment from university-based to national assessments. The role of the supervisor in direct observations of the registrar and dedicated educational meetings, giving feedback and support, cannot be overemphasized

Factors confounding the assessment of reflection: a critical review

BACKGROUND: Reflection on experience is an increasingly critical part of professional development and lifelong learning. There is, however, continuing uncertainty about how best to put principle into practice, particularly as regards assessment. This article explores those uncertainties in order to find practical ways of assessing reflection. DISCUSSION: We critically review four problems: 1. Inconsistent definitions of reflection; 2. Lack of standards to determine (in)adequate reflection; 3. Factors that complicate assessment; 4. Internal and external contextual factors affecting the assessment of reflection. SUMMARY: To address the problem of inconsistency, we identified processes that were common to a number of widely quoted theories and synthesised a model, which yielded six indicators that could be used in assessment instruments. We arrived at the conclusion that, until further progress has been made in defining standards, assessment must depend on developing and communicating local consensus between stakeholders (students, practitioners, teachers, supervisors, curriculum developers) about what is expected in exercises and formal tests. Major factors that complicate assessment are the subjective nature of reflection's content and the dependency on descriptions by persons being assessed about their reflection process, without any objective means of verification. To counter these validity threats, we suggest that assessment should focus on generic process skills rather than the subjective content of reflection and where possible to consider objective information about the triggering situation to verify described reflections. Finally, internal and external contextual factors such as motivation, instruction, character of assessment (formative or summative) and the ability of individual learning environments to stimulate reflection should be considered

Adsorption of phenolic compounds by polyacrylonitrile nanofibre membranes : a pretreatment for the removal of hydrophobic bearing compounds from water

Although Membrane Distillation (MD) is envisaged as a cost-effective alternative desalination technology, it remains severely affected by membrane fouling. In Direct Contact MD mode, membrane fouling is exacerbated by the presence of compounds bearing hydrophobic functional groups, e.g., phenols. In this study, polyacrylonitrile (PAN) and polyethylene-imine (PEI) functionalized-PAN nanofibre membranes were synthesized and tested as a pretreatment for the removal of chlorophenol and nitrophenol from solutions. PAN and PEI-modified nanofibres displayed different isoelectric points (IEP: 3.8 and 6.2, respectively), indicating the impact of the imination process. PEI-modified nanofibres showed a higher adsorption capacity for chlorophenol than for nitrophenol, and a higher adsorption capacity than PAN nanofibres for each phenolic species in the pH range tested (5-11). Electrostatic forces were the dominant interacting mechanisms influencing the adsorption capacity of nanofibres towards phenolic species, based on their IEPs and pKa. Under optimized experimental conditions, adsorption capacities ranging from 27.3 to 38.4 mg g(-1) for PAN and PEI-modified nanofibres, respectively, were recorded. Chemisorption and physisorption were proposed as main mechanisms for PEI-functionalized and PAN nanofibres, respectively; where phenols formed multilayers on the nanofibres surface leading to decreased adsorbent regeneration cycles. PEI-functionalized nanofibres showed a high potential for the removal of phenols from aqueous solutions and opens a promising research direction for their use as an innovative polymeric adsorbent during pretreatment in MD processes

Superhydrophobic PVDF nanofibre membranes coated with an organic fouling resistant hydrophilic active layer for direct-contact membrane distillation

Although Membrane Distillation (MD) is envisaged as a promising technology for achieving a cost-effective and sustainable recovery of water from saline solutions, membrane fouling and wetting remain the major challenges that compromise its separation efficiency. To mitigate the high fouling propensities of hydrophobic MD membranes while retaining their high salt rejection efficiencies, superhydrophobic poly-vinylidene fluoride (PVDF) nanofibre membranes embedded with silanized silica nanoparticles (f-SiO(2)NPs) were synthesised and coated with a hydrophilic active layer containing silver nanoparticles and carboxylated multi-walled carbon nanotubes (AgNPs/f-MWCNTs). While the f-SiO2 NPs-modified PVDF nanofibres exclusively allow the transport of water vapour, the AgNPs/f-MWCNTs active provides hydrophilic and biocidal (i.e., biofouling control) properties. The morphology, hydrophobicity, thermal and mechanical properties of the PVDF membranes were rigorously characterized. The PVDF nanofibres were investigated for their resistance to flux decline using a solution containing Bovine Serum Albumin and a real complex effluent containing thermophilic bacteria. f-SiO2 NPs-modified PVDF nanofibres showed the highest flux decline (82% after 60 h) associated with BSA adsorption induced by favourable hydrophobic-hydrophobic interactions. AgNPs/f-MWCNTs coated PVDF membranes showed a significant decrease in fouling (47% flux decline) and the highest salt rejections (99.8%). Remarkably, the coating layer showed high biocidal properties towards thermophilic bacteria when subjected to effluent. The current approach provides an important step towards a successful implementation of MD processes at a pilot-scale for water desalting

Green synthesis of silver nanoparticles using one-pot and microwave-assisted methods and their subsequent embedment on PVDF nanofibre membranes for growth inhibition of mesophilic and thermophilic bacteria

Antibacterial silver nanoparticles (AgNPs) were synthesised via an environmentally benign thermally-assisted one-pot and microwave-assisted experimental set-up using apple extract as a reducing agent. The formation of these AgNPs was confirmed by UV-Vis, XRD and EDS while their size distribution was determined by TEM micrographs. The AgNPs were uniformly distributed with diameters of 28.24 +/- 1.15 nm and 22.05 +/- 1.05 nm for the thermally-assisted one-pot and microwave-assisted reduction methods respectively. The rate of reduction was faster in a microwave-assisted reduction method compared to that of a thermally-assisted one-pot synthesis method. The antibacterial AgNPs were embedded in polyvinylidene fluoride (PVDF) nanofibre membranes and their antibacterial activity against Gram-positive Geobacillus stearothermophilus and Staphylococcus aureus and Gram-negative Pseudomonas aeruginosa and Klebsiella pneumoniae was studied. The antibacterial nanofibres successfully inhibited the growth of these mesophilic and thermophilic bacteria. Therefore, AgNP-embedded PVDF nanofibre membranes showed a high potential for use in water purification systems that are subject to contamination by mesophilic or thermophilic bacteria without compromising the rate of water recovery