Lecturers' perspectives of pedagogical training initiates at a University of Technology in KwaZulu-Natal, South Africa

Professional development of academics in higher education in South Africa has been offered in an uncoordinated and unsustainable manner. Ever since the new dispensation, concerted efforts have been implemented to address this problem. As part of the solution, universities through their academic development units, have introduced various pedagogical training workshops to equip academics with teaching skills. This study investigates perceptions of academics pertaining to this training. A multi-method cross-sectional research design was adopted to understand lecturers’ perspectives regarding professional development. A total of 45 participants were purposefully selected to participate in the study from the academics who attended the pedagogical training. A questionnaire (closed and open-ended) was used to collect data. Quantitative data were analysed using the Statistical Package for the Social Sciences (SPSS), while thematic analysis was applied to analyse qualitative data. Results of the study revealed that the training was well-received and academic staff members felt motivated and confident to implement various instructional strategies acquired from the training. Participants expressed a need and willingness to learn and develop new instructional techniques and acquired a positive outlook on teaching and learning following the professional development training. The study recommends redesigning the pedagogical training to include ongoing support activities and customisation in addition to the generic version

Using a design-based research approach for a supplementary instruction programme: A pedagogical intervention during the COVID-19 pandemic

The study focused on the implementation of supplementary instruction as a suitable and effective pedagogical intervention for assisting at-risk students enrolled in an Advanced Research Methodology core course in one of the South African higher education institutions (HEIs). Supplementary instruction (SI) has been purported to be an effective technique for assisting at-risk students undertaking high-risk core modules. The educational challenge of at-risk students in higher education has been worsened by the emergence of the COVID-19 pandemic where high-risk core modules implementing e-learning posed serious challenges for at-risk students thereby negatively affecting pass rates and throughput. The design-based research (DBR) approach was used to guide the design of the intervention and research its effectiveness. The article reports on the design principles that yielded these results. After one cycle of DBR, it was established that SI had a positive impact on the pass rates of this particular course. The article argues that the use of the proposed designed principles in SI interventions has the potential to increase higher mean grades, lower failure and withdrawal rates, and higher retention rates of students. However, this study recommends that further iterations must be undertaken to refine design principles for an SI programme of this nature. The pedagogical significance of the current study in the prevailing circumstances and post COVID-19 pandemic is implementing a robust SI intervention in all core modules at the University of Technology

Community perceptions of the socio-economic structural context influencing HIV and TB risk, prevention and treatment in a high prevalence area in the era of antiretroviral therapy

Following calls for targeted HIV prevention interventions in so-called “hotspots”, we explored subjective perceptions of community members in places considered to be high HIV and tuberculosis (TB) transmission areas and those with low prevalence. Although more people now have access to antiretroviral therapy (ART), some areas are still experiencing high HIV transmission rates, presenting a barrier to the elimination of HIV. A rapid qualitative assessment approach was used to access a sample of 230 people who contributed narratives of their experiences and perceptions of transmission, treatment and prevention of HIV and TB in their communities. Theoretical propositions case study strategy was used to inform and guide the thematic analysis of the data with Research Department of Epidemiology & Public Health, University College London, London, UK. Our results support the concept of linking perceived control to health through the identification of structural factors that increase communities’ sense of agency. People in these communities did not feel they had the efficacy to effect change in their milieu. The few socio-economic opportunities promote social mobility in search of better prospects which may have a negative impact on community cohesion and prevention strategies. Communities were more concerned with improving their immediate social and economic situations and prioritised this above the prevention messages. Therefore approaches that focus on changing the structural and environmental barriers to prevention may increase people’s perceived control. Multifaceted strategies that address the identified constructs of perceived control may influence the social change necessary to make structural interventions successful

Descriptive analysis of World Health Organization-recommended second-line antiretroviral treatment: A retrospective cohort data analysis

Background. World Health Organization guidelines recommend that HIV patients who do not achieve viral suppression on efavirenz-based first-line antiretroviral therapy (ART) should be changed to a protease inhibitor (PI)-based regimen. In South Africa (SA), ~200 000 people are on second-line treatment, but little is known about these patients.Objectives. To describe second-line black African patients in a large urban area.Methods. A quantitative retrospective study of 825 second-line patients in central Johannesburg, SA (subdistrict F), was performed with data extracted from government databases. Demographic characteristics, treatment status and laboratory information were gathered, then analysed with CD4+ cell count, viral load (VL) and retention-in-care data as outcome variables.Results. The average recorded time to VL measurement after the switch to a PI-based ART regimen was 20 months, and 83.1% (570/686) of patients with a recent VL achieved viral suppression while on second-line treatment. The most recent median CD4+ cell count for the cohort was 286 cells/µL (interquartile range 160 - 478), which represented a 177 cells/µL increase from the baseline count at the start of first-line ART. Slightly less than three-quarters (72.4%) of the population remained active in care in the study clinics from initiation on first-line ART. Demographic characteristics such as being <25 years of age, male sex and geographical transfer (started initial treatment in a different region) independently predicted low CD4+ cell counts and virological failure on second-line treatment. Patients with virological failure were most likely (odds ratio (OR) 3.13, 95% confidence interval (CI) 1.50 - 6.56) to be lost to follow-up after the switch, while patients from Hillbrow Community Health Centre (OR 0.27, 95% CI 0.16 - 0.44), South Rand Hospital (OR 0.24, 95% CI 0.12 - 0.47) and Jeppe Clinic (OR 0.38, 95% CI 0.16 - 0.88), three larger sites, were most likely to remain active in care.Conclusions. VL suppression was high in patients on second-line treatment, but one-fifth of patients were lost to follow-up. Younger age, male sex and transfer from other treatment sites predicted poor treatment outcomes, highlighting opportunities for prioritisation of adherence interventions.

Malaria control-two years' use of insecticide treated bednets compared with insecticide house spraying in KwaZulu-Natal

Objectives. The objective of this study was to produce data indicating whether insecticide-treated bednets should replaced insecticide house spraying as a malaria control method in South Africa. We report 2 years of preliminary data on malaria incidence comparing areas receiving insecticidetreated bednets and those subjected to house spraying in northern KwaZulu-Natal.Design, setting and subjects. In order to measure significant reductions in malaria incidence between the two interventions, a geographical information system (GIS) was used to identify and create seven pairs of geographical blocks (areas) in the malaria high-risk areas of Ndumu and Makanis in Ingwavuma magisterial district, KwaZulu-Natal. Individual blocks were then randomly allocated to either insecticide-treated bednets or house spraying with  deltamethrin. Malaria cases were either routinely recorded by surveillance agents at home or were reported to the nearest health facility.Results and conclusions. The results show that 2 years' use of insecticide-treated bednets by communities in Ndumu and Makanis, KwaZulu-Natal, significantly reduced the malaria incidence both in 1997 (rate ratio (RR) = 0.879, 95% confidence interval (CI) 0.80- 0.95, P = 0.04) and in 1998 (RR = 0.667, CI 0.61 - 0.72, P= 0.0001). Using a t-test, these significant reductions were further confirmed by an assessment of the rate of change between 1996 and 1998, showing a 16% reduction in malaria incidence in blocks using  treated bednets and an increase of 45% in sprayed areas (t =2.534, P = 0.026 (12 df)). In order to decide whether bednets should replace house spraying in South Africa, we need more data on the efficacy of treated bednets, their long-term acceptability and the cost of the two interventions

Opportunities for technologically driven dialogical health communication for participatory interventions: Perspectives from male peer navigators in rural South Africa

There is increasing interest in the potential to deliver participatory dialogical HIV and intimate partner violence (IPV) prevention interventions via digital platforms, though the majority of mHealth interventions have been didactic in approach. We undertook 10 in-depth interviews with male Peer Navigators (PNs) who had been extensively trained and working on a larger intervention promoting young people's sexual and reproductive rights, in rural KwaZulu-Natal. Interviews focused on their, and their peers', use of technology in their everyday lives. Data were transcribed and translated, and subjected to thematic analysis. PNs described structural barriers to the use of technology, including poor connectivity, high data costs, and erratic electricity. They primarily used Facebook and WhatsApp for communication and highlighted how reading messages asynchronously was important to overcome connectivity challenges. PNs shared how groups were primarily for information sharing, they also discussed 'sensitive' issues online. Privacy was a concern, especially for conversations, and there was recognition of how confidentiality could be breached. It was also felt that WhatsApp could potentially support greater openness in discussions. We reflect on the potential for online interventions to support dialogical health communication, highlighting how dialogical health communication may be enabled through information provision, the asynchronous communication enhancing the potential for reflection, and greater participation in discussion by those who are shyer. Despite this potential there remain important risks around privacy of discussions and how to implement these approaches online

Malaria control – two years' use of insecticide treated bednets compared with insecticide house spraying in Kwazulu-Natal

Objectives_ The objective of this study was to produce data indicating whether insecticide-treated bednets should replac insecticide house spraying as a malaria control method in South Africa_ We report 2 years of preliminary data on malaria incidence comparing areas receiving insecticidetreated bednets and those subjected to house spraying in northern KwaZulu-Natal.Design, setting and subjects. In order to measure significant reductions in malaria incidence between the two interventions, a geographical information system (GIS) was used to identify and create seven pairs of geographical blood ; (areas) in the malaria high-risk areas of Ndumu and Makani in Ingwavuma magisterial district, KwaZulu-Natal, Individual blocks were then randomly allocated to either insecticide-treated bednets or house spraying with deltamethrin. Malaria cases were either routinely recorded by surveillance agents at home or were reported to the nearest health facility_Results and conclusions. The results show that 2 years' use of insecticide-treated bednets by communities in Ndumu and Makanis, KwaZulu-Natal, significantly reduced the malaria incidence both in 1997 (rate ratio (RR) =0_879, 95% confidence interval (Cn 0.80 - 0.95, P =0.04) and in 1998 (RR = 0.667, Cl 0_61 - 0.72, P = 0.0001). Using a t-test, these significant reductions were further confirmed by an assessment of the rate of change between 1996 and 1998, showing a 16% reduction in malaria incidence in blocks using bednets and an increase of 45% in sprayed areas (t = 2.534, P = 0.026 (12 df». In order to decide whether bednets : should replace house spraying in South Africa, we need more : data on the efficacy of treated bednets, their long-term acceptability and the cost of the two interventions

Sources of social support and sexual behaviour advice for young adults in rural South Africa

Introduction While young people in sub-Saharan Africa (SSA) are at greatest risk of HIV acquisition, uptake of HIV prevention interventions among them has been limited. Interventions delivered through social connections have changed behaviour in many settings, but not to date in SSA. There is little systematic evidence on whom young SSA adults turn to for advice. We therefore conducted an exploratory cross-sectional study from whom young rural South Africans received support and sexual behaviourspecific advice. Methods We asked 119 18–34 year olds in rural KwaZulu-Natal about the important people in their lives who provided emotional, informational, financial, physical, social or other support. We also asked whether they had discussed sex or HIV prevention with each contact named. We used descriptive statistics and logistic regression to analyse support and advice provision patterns. Results Respondents named 394 important contacts, each providing a mean of 1.7 types of support. Most contacts were relatives, same-gender friends or romantic partners. Relatives provided most informational, financial and physical support; friends and partners more social support and sexual advice. Respondents reported discussing sexual matters with 60% of contacts. Sources of support changed with age, from friends and parents, towards siblings and partners. Discussion Sexual health interventions for young adults in rural South Africa may be able to harness friend and samegeneration kin social ties through which sex is already discussed, and parental ties through which other forms of support are transmitted. The gender-segregated nature of social connections may require separate interventions for men and women

The demographic and clinical profiles of women presenting with vaginal discharge syndrome at primary care facilities in South Africa: Associations with age and implications for management

Background. Current South African guidelines for the management of vaginal discharge syndrome (VDS) do not recommend treatment for sexually transmitted infection (STI) pathogens for women aged ≥35 years whose partners do not have male urethritis syndrome. The guideline assumes that older women are unlikely to have an STI and that their partners do not have asymptomatic infections.Objectives. To describe the demographic, behavioural and clinical characteristics of women with VDS, comparing older women (≥35 years) with younger women, and to determine the performance of age alone as a criterion for predicting the presence of STI.Methods. This was a cross-sectional study at seven primary healthcare centres taking part in the aetiological surveillance of STIs between January 2015 and December 2016. Eligible women presenting with VDS were enrolled and completed a nurse-administered questionnaire. Genital swabs and blood specimens were collected for laboratory testing. Data were entered into surveillance-specific databases and exported into Stata 14 for analysis. Descriptive statistics were used to compare demographic and clinical profiles of older with younger women. A receiver operator curve (ROC) was used to determine the age cut-off that would best differentiate between women who had infection with STI pathogens and those without.Results. Of 757 women enrolled, 157 (20.7%) were aged ≥35 years. HIV positivity was 46.6%, and higher in older than younger women (54.9% v. 44.5%; p=0.02). Of those enrolled, 283 (37.4%) had bacterial vaginosis (BV) and/or Candida infection only, 232 (30.7%) had BV or Candida with STI pathogens detected, 98 (13%) were infected with STI pathogens only, and 144 (19.0%) did not have any detectable STI or non-STI causes. Although older women were less likely than younger women to have Neisseria gonorrhoeae, Chlamydia trachomatis or Mycoplasma genitalium infection (23.6% v. 38.2%; p<0.01), the burden in older women was not negligible. The area under the ROC for age was 57.5% (95% confidence interval 53.2 - 61.8%), which implies suboptimal performance.Conclusions. Although older women with VDS were less likely than younger women to have STIs, a significant proportion of them did have an infection with STI pathogens. Age alone was not a good criterion for discriminating between women with and without infection with STI pathogens. Other ways of improving the VDS algorithm performance are needed, as is better integration of HIV and STI prevention and treatment.Â

Modelling coal rent, economic growth and CO2 emissions: Does regulatory quality matter in BRICS economies?

Global warming issues have been on the front burner of most economies and Brazil, Russia, India, China and South Africa countries (BRICS) are no exception. The region has joined the rest of the world on the global strides to mitigate against global warming in terms of decoupling carbon dioxide emissions from economic growth. This is the motivation for the present study to consider the interaction between economic growth, pollutant emissions, coal rent while accounting for the role of other covariates like regulatory quality. The study is conducted in a balanced panel setting over annual frequency data from 1990 to 2014. To this end, Pooled mean group with dynamic autoregressive distributed lag [PMG-ARDL (1,1,1,1,1)] was conducted to explore the coal-rents-energy nexus. The empirical study shows that for BRICS countries, unlike coal consumption, coal rents have a significant but negative impact on CO2 emissions. Also, in contrast to expectation, regulations on coal rents in the form of carbon damage costs have a significant but positive impact on CO2 emissions. This suggests that in line with the drive for growth by BRICS countries, and to achieve a reduction in the levels of CO2 emissions for green growth and sustainable development, more stringent environmental-energy-related regulations are inevitable. Thus, for policymakers, it is vital to reinforce the use of stringent regulations as these economies open up to more use of coal energy. However, the need to shift, the energy mix in BRICS to renewables is pertinent in a time of global environmental consciousness for cleaner energy sources and environmentally friendly ecosystem