Training primary care nurses to conduct alcohol screening and brief interventions in South Africa

Although progress has been made in developing a scientific basis for alcohol screening and brief intervention (SBI), training packages are necessary for its widespread dissemination in primary care settings in developing societies. Using a training package developed by the World Health Organisation 121 nurses from one rural site (29 clinics in Vhembe District) and one urban site (3 clinics and 6 mobile clinics in Polokwane/ Seshego) in South Africa were compared before and after SBI training regarding knowledge and attitudes, and the subsequent practice of SBI in routine clinical practice. Although the training effects were at times moderate, all changes were in a direction more conducive to implementing SBI. Health care providers significantly increased in knowledge, confidence in SBI and higher self-efficacy in implementing SBI at followup after 9 months after receiving the training. When delivered in the context of a comprehensive SBI implementation programme, this training is effective in changing providers’ knowledge, attitudes, and practice of SBI for at-risk drinking

Vertebrate Vitellogenin Gene Duplication in Relation to the “3R Hypothesis”: Correlation to the Pelagic Egg and the Oceanic Radiation of Teleosts

The spiny ray-finned teleost fishes (Acanthomorpha) are the most successful group of vertebrates in terms of species diversity. Their meteoric radiation and speciation in the oceans during the late Cretaceous and Eocene epoch is unprecedented in vertebrate history, occurring in one third of the time for similar diversity to appear in the birds and mammals. The success of marine teleosts is even more remarkable considering their long freshwater ancestry, since it implies solving major physiological challenges when freely broadcasting their eggs in the hyper-osmotic conditions of seawater. Most extant marine teleosts spawn highly hydrated pelagic eggs, due to differential proteolysis of vitellogenin (Vtg)-derived yolk proteins. The maturational degradation of Vtg involves depolymerization of mainly the lipovitellin heavy chain (LvH) of one form of Vtg to generate a large pool of free amino acids (FAA 150–200 mM). This organic osmolyte pool drives hydration of the ooctye while still protected within the maternal ovary. In the present contribution, we have used Bayesian analysis to examine the evolution of vertebrate Vtg genes in relation to the “3R hypothesis” of whole genome duplication (WGD) and the functional end points of LvH degradation during oocyte maturation. We find that teleost Vtgs have experienced a post-R3 lineage-specific gene duplication to form paralogous clusters that correlate to the pelagic and benthic character of the eggs. Neo-functionalization allowed one paralogue to be proteolyzed to FAA driving hydration of the maturing oocytes, which pre-adapts them to the marine environment and causes them to float. The timing of these events matches the appearance of the Acanthomorpha in the fossil record. We discuss the significance of these adaptations in relation to ancestral physiological features, and propose that the neo-functionalization of duplicated Vtg genes was a key event in the evolution and success of the teleosts in the oceanic environment

Prevalence and perception of alcohol use in a rural community in South Africa: a pre-intervention survey

Paper presented at the Symposium on Screening and Brief intervention of alcohol problems in South Africa, Turfloop, University of the North, 7 AprilThe aim of this study was to assess the prevalence and perception of alcohol use in a rural community in South Africa and to correlate this with socio-demographic characteristics, knowledge and risk perception of alcohol use. Results are discussed in view of community interventions of harmful and hazardous alcohol use

Evaluation of HIV/AIDS prevention intervention messages on a rural sample of South African youth's knowledge, attitudes, beliefs and behaviours over a period of 15 months

The aim of this study is to evaluate HIV/AIDS prevention intervention messages in a large rural youth population (15-24 years) in South Africa over a period of 15 months. A representative community sample of 421 youth at time one and 416 at time two participated in the study using a three-stage cluster sampling method for a household survey. Results show that over a period of 15 months sexual risk behaviour reduced (multiple partners) and the number of sexually transmitted symptoms reduced. Attitudes towards persons living with HIV/AIDS improved partly due to mass media and to a lesser extent through community interventions and partly determined by the high level of mortality experienced in the studied communities. Peer educators had a significant impact on HIV/AIDS knowledge and favourable attitude towards people living with HIV/AIDS, magazines on lower HIV risk behaviour and exposure to HIV/AIDS radio messages on consistent condom use. In this African sample of youth the reduction of sexual partners seem to be more feasible than (consistent) condom use to prevent STD and HIV infection.

Characteristics of female sex workers and their HIV/AIDS/STI knowledge, attitudes and behaviour in semi-urban areas in South Africa

The aim of this study was to investigate characteristics of female sex workers and their HIV/AIDS/STI knowledge, attitudes and behaviour in semi-urban areas in South Africa. The sample included 70 female sex workers from the Tzaneen and Phalaborwa area in the Limpopo Province. A modified form of snowball sampling known as “targeted” sampling was used for identifying female sex workers. Results showed an inadequate knowledge of HIV prevention methods and some incorrect beliefs about AIDS transmission. Most sex workers reported condom use with their last sex client, inconsistent condom use with paying partners, and had poor condom use with regular partners. One third were drinking alcohol daily, one quarter had had voluntary HIV tests, and three quarters had been exposed to HIV interventions. Findings are discussed and implications for HIV interventions outlined

Factors at first diagnosis of tuberculosis associated with compliance with the Directly Observed Therapy (DOT) in the Limpopo Province, South Africa

The aim of this study is to compare and contrast health beliefs, demographic and socio-economic variables, causative beliefs, knowledge, health-seeking behaviour and health provider-patient interaction of compliant and non-compliant tuberculosis patients. The sample included 219 consecutive new sputum-smear and/or culture positive pulmonary tuberculosis patients registered between October 1999 and March 2000 in three hospitals in the Limpopo Province of South Africa. The patients were 144 (65.8%) men and 75 (34.2%) women in the age range of 18 to 79 years (M age 35.9 yr., SD= 12.6). The consultation at first diagnosis was observed and tape-recorded. Thereafter an interview was conducted and a questionnaire was face-to-face administered with the patient including knowledge, causative beliefs, health seeking, and Health Belief Model items. Discriminant analysis between compliant and non-compliant groups after six months follow-up showed that the quality of the health practitioner-patient interaction and causative belief were associated with compliance behaviour whereas knowledge, onset of TB, sociodemographic variables, health care seeking, and health beliefs were not associated

Training primary care nurses to conduct alcohol screening and brief interventions in South Africa

Although progress has been made in developing a scientific basis for alcohol screening and brief intervention (SBI), training packages are necessary for its widespread dissemination in primary care settings in developing societies. Although the training effects were at times moderate, all things were in a direction more conductive to implementing SBI. Health care providers significantly increased in knowledge, confidence in SBI and higher self-efficacy in implementing SBI at follow-up after 9 months after receiving the training. When delivered ion the context of a comprehensive SBI implementation programmed, this training is effective in changers providers' knowledge attitudes and practice of SBI for at-risk drinking.

Training primary care nurses to conduct alcohol screening and brief interventions in the Limpopo Province

Paper presented at the Symposium on Screening and Brief Intervention of Alcohol Problems in South Africa, Turfloop, University of the North, 7 AprilAlthough progress has been made in developing a scientific basis for alcohol screening and brief intervention (SBI), training packages are necessary for its widespread dissemination in primary care settings in developing societies. This paper evaluates a training package developed by the World Health Organisation, the SBI programme