High prevalence of depression symptomology among adolescents in Soweto,South Africa associated with being female and cofactors relating to HIV transmission

Adolescents in HIV endemic settings are a priority demographic with respect to HIV prevention. Some studies have shown that behaviours associated with HIV transmission, may be mediated by mental health factors such as depression. We undertook this study to explore the prevalence and associations of depression symptomology among adolescents living in the HIV endemic community of Soweto, South Africa through the Botsha Bophelo Adolescent Health Study (BBAHS). We estimated the prevalence of depression using the Centre for Epidemiological Studies of Depression Scale, using a score of ≥24 to indicate ‘probable depression’. Among the 789 adolescents (14–19 years) with depression scores, 262 (33%) met the criteria for probable depression (99 [38%] men and 163 [62%] women; p = 0.061). In multivariable logistic regression, factors independently associated with depression included being female (AOR = 2.44, 95% CI: 1.45–4.00), marijuana use (AOR = 2.67, 95% CI: 1.21–5.93), physical violence (AOR = 1.63, 95% CI: 1.01–2.62), pregnancy (AOR = 2.00, 95% CI: 1.03–3.88) and incarceration (AOR = 2.09, 95% CI: 0.99–4.42). These data indicate that a concerning proportion of adolescents in Soweto may be suffering from depression and those screened as potentially depressed, were more likely to be female and have cofactors relating to increased risk for HIV. As part of a comprehensive HIV prevention strategy, we recommend that depression screening for adolescents be integrated into public and school health programs that triage those suffering into treatment programs.     

Motivators of adherence to integrated management among patients with chronic kidney disease: A qualitative study

The integrated management of chronic kidney disease (CKD) demands significant changes, as patients need to adhere to dialysis, medication, and dietary and fluid restrictions. Therefore, there is a need to identify the motivators of adherence to improve the quality of life of these patients. The aim of the present study was to explore the motivators of adherence to integrated management among patients with CKD in South Africa. A phenomenological design was used. A sample size of 12 participants was selected according to data saturation. The purposive sampling method was used to select the participants. Data were collected with the help of a semistructured interview schedule developed from the literature. A thematic framework analysis was conducted to identify the motivators of adherence to integrated management; these were found to be family support, anxiety about eligibility for kidney transplant, support of other patients, awareness of complications associated with non‐adherence to integrated management, and fear of being removed from the CKD program. Identified motivators could be used to develop specific interventions that address or foster adherence behavior as a requirement for integrated management.     

Fulbright Scholar opportunities for global health and women's health care in HIV/AIDS in sub-Saharan Africa

This article addresses global health opportunities related to HIV/AIDS and women's health care in sub-Saharan Africa through Fulbright Scholar and Fulbright Student Awards. Although many universities offer a gateway to the J. William Fulbright awards, some disciplines and areas of specialization, including nursing and women's health, have had fewer scholars or students as recipients of these awards. Resource-limited countries, including the countries of sub-Saharan Africa, offer rich opportunities for cross-cultural exchange and advancement of global health. Amidst the context of the shortage of health care workers, the increasing prevalence of HIV/AIDS and other infectious and chronic diseases in sub-Saharan Africa, and the challenges of public health, this article addresses an example of partnerships in global nursing that can be developed through the Fulbright programs.     

Volumetric Analysis of the African Elephant Ventricular System

This study used magnetic resonance imaging (MRI) to determine the volume of the ventricular system in the brain of three adult male African elephants (Loxodonta africana). The ventricular system of the elephant has a volume of ～240 mL, an order of magnitude larger than that seen in the adult human. Despite this large size, allometric analysis indicates that the volume of the ventricles in the elephant is what one would expect for a mammal with an ～5 kg brain. Interestingly, our comparison with other mammals revealed that primates appear to have small relative ventricular volumes, and that megachiropterans and microchiropterans follow different scaling rules when comparing ventricular volume to brain mass indicating separate phylogenetic histories. The current study provides context for one aspect of the elephant brain in the broader picture of mammalian brain evolution. Anat Rec, 2011. © 2011 Wiley‐Liss, Inc.     

Distribution and morphology of catecholaminergic and serotonergic neurons in the brain of the highveld gerbil, Tatera brantsii

The distribution, morphology and nuclear subdivisions of the putative catecholaminergic and serotonergic systems within the brain of the highveld gerbil were identified following immunohistochemistry for tyrosine hydroxylase and serotonin. The aim of the present study was to investigate possible differences in the complement of nuclear subdivisions of these systems when comparing those of the highveld gerbil with those of the laboratory rat. The highveld gerbil was chosen as it is relatively closely related to the laboratory rat, but the Gerbillinae and Murinae lineages diverged over 20 million years ago. Moreover, even though brain sizes are similar, the life history and phenotypes between these two species are substantially different. The gerbils used in the present study were caught from the wild, which is again another contrast to the laboratory rat. While these differences may lead to the prediction of significant differences in the nuclear complement of these systems, we found that all nuclei identified in both systems in the laboratory rat in several earlier studies had direct homologs in the brain of the highveld gerbil. Moreover, there were no additional nuclei in the brain of the highveld gerbil that are not found in the laboratory rat. The only discernable difference between the two species was a greater density and number of catecholaminergic neurons in the olfactory bulb of the highveld gerbil. Thus, the evolution of nuclear parcellation in these systems appears to demonstrate a form of phylogenetic constraint related to the order Rodentia.     

Predictors of vaginal practices for sex and hygiene in KwaZulu-Natal, South Africa: findings of a household survey and qualitative inquiry

Vaginal practices in sub-Saharan Africa may increase HIV transmission and have important implications for development of microbicides and future HIV prevention technologies. It remains unclear which women undertake vaginal practices and what factors predict prevalence, practice type and choice of products. Using cross-sectional data from mixed research methods, we identify factors associated with vaginal practices among women in KwaZulu-Natal, South Africa. Data were gathered through focus group discussions, in-depth and key-informant interviews, followed by a province-wide, multi-stage cluster household survey, using structured questionnaires in face-to-face interviews with 867 women. This paper details six types of vaginal practices, which--despite their individual distinctiveness and diverse motivations--may be clustered into two broad groups: those undertaken for purposes of 'hygiene' (genital washing, douching and application) and those for 'sexual motivations' (application, insertion, ingestion and incisions). Multivariate analysis found significant associations between 'hygiene' practices and media access, religiosity and transactional sex. 'Sexual' practices were associated with partner concurrency, religiosity and use of injectable hormonal contraceptives. Future interventions relating to vaginal practices as well as microbicides need to reflect this characterisation of practices as sexual- and/or hygiene-related.     

Elephants Have Relatively the Largest Cerebellum Size of Mammals

The current study used MR imaging to determine the volume of the cerebellum and its component parts in the brain of three adult male African elephants (Loxodonta africana) and compared this with published data from Asian elephants and other mammalian species including odontocete cetaceans, primates, chiropterans, insectivores, carnivores, and artiodactyls. The cerebellum of the adult elephant has a volume of ～925 mL (average of both African and Asian species). Allometric analysis indicates that the elephant has the largest relative cerebellum size of all mammals studied to date. In addition, both odontocete cetaceans and microchiropterans appear to have large relative cerebellar sizes. The vermal and hemispheric components of the African elephant cerebellum are both large relative to other mammals of similar brain size, however, for odontocete cetaceans the vermal component is small and the hemispheric component is large. These volumetric observations are related to life‐histories and anatomies of the species investigated. The current study provides context for one aspect of the elephant brain in the broader picture of mammalian brain evolution. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc.