Inconsistent Counselor Fidelity in Delivering an Evidence-Based Adherence Intervention During a PrEP Trial

AIDS and Behavior - Evidence-based adherence counseling interventions must be delivered with fidelity to ensure that their effectiveness is retained, but little is known regarding how counselors in...     

Research integrity and misconduct: a clarification of the concepts

The commercialization of research and the ever changing scientific environment has led scholars to shift the focus from promoting research integrity to regulating misconduct. As a result, most literature explains research integrity in terms of avoidance of misconduct. The purpose of the paper is to stimulate reflection and discussion on research integrity and research misconduct. This article explores the meaning of research integrity and research misconduct, and how research integrity can be promoted to ensure safer research and scholarship. We believe that the discussion can help clarify some hazy areas in the research and publication processes, and appreciate some crucial aspects that they may have seen taken for granted. The purpose of this article is to share with the readers some clarification or analysis of the two concepts namely: research integrity and misconduct. The objectives are: (1) To explore and analyse the concepts of research integrity and research misconduct from the educational or developmental perspective and not the legal perspective as others in literature have done. (2) To stimulate the reflection and discussion on strategies to promote research integrity and thus prevent research misconduct Literature review and concept analysis was undertaken to clarify the two concepts. We argue that the two concepts can be viewed along a continuum, i.e. where research integrity ends, research misconduct starts. We also argue that it is the responsibility of the research community at large to always ensure that the scientific ethics balance is maintained throughout the research process to ensure research integrity and avoid research misconduct. We also argue that research integrity is interlinked with morality while misconduct is interlinked with immorality.     

HIV Prevention in Action on the Football Field: The Whizzkids United Program in South Africa

The Africaid Trust is a grassroots South African non-profit organization that engages youth in HIV prevention by harnessing the popularity of football (i.e. soccer). WhizzKids United, the organization’s primary program, operates a 12-week program in elementary schools in Pietermaritzburg, South Africa, which aims to impart knowledge and life skills critical to HIV prevention. The goal of this research was to compare elementary school youth who received the program to youth who only received traditional classroom-based HIV education on health behaviors and HIV-related knowledge and stigma. A secondary objective was to evaluate HIV knowledge, sexual behaviors, attitudes towards HIV and health care seeking behaviors among South African youth in grades 9–12. Elementary students who participated in the program reported greater HIV knowledge and lower HIV stigma (p < .001) than those who had not. The majority of youth in grades 9–12 report having sexual relations (55.6 %), despite low levels of HIV testing (29.9 %) in this high HIV prevalence region of South Africa. The results highlight the importance of supporting community-based HIV educational initiatives that engage high-risk youth in HIV prevention and the need for youth-friendly health services.     

Experiences of student nurses in a multicultural nurse-patient encounter

South African nurses have accepted the challenge that was brought about by the Health Reform Policy of 1990 which decreed that health service centres be opened to people of all cultural and racial groups. However, studies on transcultural; nursing have revealed that, problems have occurred during a multicultural nurse patient encounter. Most of these studies have approached the problems from the patients point of view, this study was therefore an attempt to look into the problem from the nurses point of view. The researcher was interested in exploring the sources of such problems, their effects on the nurse patient relationship as well as to find out from the respondents, the possible solutions to such problems. Through focus group interviews (FGI), respondents who had experienced problems with culturally different patients were given an opportunity to reflect on those experiences, report on these and recommend possible solutions. The results revealed that differing perceptions about the encounter between the nurse and the patient, previous experience which led to the formation of stereotypes, was the major source of problems. The results further revealed that stereotype relevant information, if used during the nurse patient encounter, led to inadequate care delivery. The solution to the problem according to the results, would be a positive approach to the problem of cultural differences.     

The development of the model for recognition of prior learning for nurses in South Africa: development of RPL guidelines by the policy makers and stakeholders of nursing

The National Qualifications Framework (NQF) was established to address the compartmentalization of education and training, the absence of norms and standards and the need for international recognition. According to the South African Qualifications Authority (1996),this framework was aimed at developing a comprehensive qualifications structure and an integrated approach to education and training in the country (NCHE, 1996:46). Educational institutions, including those for nursing, were challenged with a view to rethink the whole culture of teaching and learning and was counted as knowledge. The major principle of the NQF was the Recognition of Prior Learning (RPL), which had to be persued across all sectors (Musker, 1998: 8). RPL was seen as a means to widen access into learning programs for those who had been historically denied this. The challenge for educational institutions was how to ensure that RPL systems once implemented did not compromise academic standards. Research into methodologies to implement the NF in the absence of mechanisms was then essential. The purpose of the study was to develop and test a RPL model for nurses in South Africa. The study adopted a multi phase decisions-oriented evaluation research design. Stuffelbeam's educational evaluation model was used to guide data collection and analysis. The research questions were incorporated under the different phases of evaluation. The model was development at six levels: level one was at the policy makers level; level two was at the stakeholders; levels three to six were at institutional level where three institutions participated at pilot site for the RPL model development. These levels are presented as tiers in the figure 1. This article present the results of the model development at the first two levels, which according to Stuffelbeam's model is the context evaluation for boundary setting. Part two will present the model development at institutional level, involving the input and process evaluation and depicted as tiers three, and four.     

A comparative study of supercritical fluid extraction and accelerated solvent extraction of lipophilic compounds from lignocellulosic biomass

The Box-Behnken experimental design technique investigated a comparative study of supercritical fluid extraction (SFE) and accelerated solvent extraction (ASE) of lipophilic compounds from pinewood sawdust. A response surface methodology was used to examine the effect of independent parameters and optimize the extraction yield of lipophilic compounds. The results showed that the increase in extraction temperature used for ASE positively influenced the yield of lipophilic compounds, whereas an increase in the flow rate of the cosolvent at temperature 50 °C, and pressure of 300 bar increased the yield achieved by SFE. The experimental data's quadratic polynomial models gave a coefficient of determination (R²) of 0.87 and 0.80 for ASE and SFE, respectively. The optimum conditions of ASE were temperature (160 °C), static time (12.5 mins), and static cycle (1), which resulted in a maximum yield of 4.2%. The optimum SFE conditions were temperature (50 °C), pressure (300 bar), carbon dioxide (CO₂) flow rate (3.2 ml/min), and a 2 ml/min cosolvent flow rate that yielded 2.5% lipophilic compounds. ASE yielded higher extraction efficiency than SFE. Fourier transform infra-red (FTIR) spectroscopy and thermal analyses TGA/DSC evaluated the ultimate analyses of the lipophilic extracts. The FTIR results confirmed the presence of aliphatic groups, hydroxyl groups, and carboxyl groups. The thermal analysis showed that the degradation temperature of the lipophilic compounds occurred between 250 and 450 °C. Thereafter, Pyrolysis-Gas Chromatography Mass Spectrometry (Py-GC/MS) was used to identify the lipophilic compounds, which showed that the extracts were rich in fatty acids and terpenes.     

Serum cystatin C for assessment of glomerular filtration rate in hypertensive disorders of pregnancy.

BACKGROUND: Assessment of renal function is important in the evaluation of the pregnant hypertensive patient. The aim of this study was to evaluate the diagnostic utility of cystatin C as a marker of glomerular filtration rate in hypertensive disorders of pregnancy and to correlate this with serum creatinine and creatinine clearance. METHODS: For our study, 198 women who presented with hypertension during pregnancy were recruited at the antenatal clinic of King Edward VIII Hospital in Durban, South Africa, a tertiary referral centre. Exclusion criteria included women with eclampsia, urinary tract infection and chronic renal disease. Routine dipstick urinalysis (Bayer) was performed by midwives to classify patients suffering from the different forms of hypertensive disorders of pregnancy and venous blood samples for determination of serum cystatin C and serum creatinine were collected. The 24-hour urine creatinine clearance was used as the "gold standard" for evaluation of glomerular filtration rate due to concerns of radiation exposure to pregnant women with the use of radio nucleotide markers. RESULTS: The results of testing the 198 women, 72 of whom had preeclampsia, were analyzed. Serum cystatin C showed a significant correlation with creatinine clearance at the 0.01 level (2-tailed) with an r-value of -0.311. Serum creatinine showed a significant correlation with creatinine clearance at the 0.01 level (2-tailed) with an r-value of -0.486. CONCLUSION: Serum cystatin C seems to reflect glomerular filtration rate reliably in hypertensive pregnant women and avoids the inaccuracy associated with the 24-hour urine collection, which is time consuming and subject to improper collection.     

Poor rates of linkage to HIV care and uptake of treatment after home-based HIV testing among newly diagnosed 15-to-49 year-old men and women in a high HIV prevalence setting in South Africa

ABSTRACT

Early antiretroviral therapy (ART) initiation is essential, but linkage to care following community-based services is often poor, and inadequately understood. This study examined factors influencing linkage to care following home-based HIV-testing services (HBHTS) in a hyper-endemic setting in South Africa. HBHTS was offered to participants (N?=?10,236) enrolled in the second HIV Incidence Provincial Surveillance System survey (2015–2016), KwaZulu-Natal. Follow-up telephone surveys with 196 of the 313 individuals diagnosed HIV-positive through HBHTS were used to measure linkage to care (i.e., a clinic visit within 12 weeks) and ART-initiation. Among newly diagnosed individuals (N?=?183), 55% linked to care, and 21% of those who were ART-eligible started treatment within 12 weeks. Linkage to care was less likely among participants who had doubted their HIV-diagnosis (aOR:0.46, 95%CI: 0.23–0.93) and more likely among participants who had disclosed their HIV-status (aOR:2.31, 95%CI: 1.07–4.97). Reasons for not linking to care included no time (61%), only wanting to start treatment when sick (48%), fear of side-effects (33%), and not believing the HIV-diagnosis (16%). Results indicate that HBHTS needs to be paired with targeted interventions to facilitate early linkage to care. Interventions are required to counter denial of HIV status and facilitate early linkage to care among healthier individuals.