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Despite high levels of alcohol-related injury in South Africa, there are no screening and brief intervention (SBI) programs in any hospital trauma centres. We conducted semistructured interviews with 16 trauma centre staff (8 doctors, 7 nurses, 1 social worker) focused on barriers and enablers to the future implementation of a SBI program. Data were analysed using thematic analysis. Perceived barriers included time constraints and injury treatment as priority, with the central barrier being inadequate funding. Enablers included the support of senior staff, and training. These findings can be used to support the successful implementation of a SBI program in South African trauma centres, with the purpose of reducing high rates of risky alcohol use and related injury recidivism.&nbsp

Supplemental material, sj-docx-1-vaw-10.1177_10778012231188090 for Co-Occurrence of Intimate Partner Violence Against Mothers and Maltreatment of Their Children With Behavioral Problems in Eastern Europe by Antonia Brühl, Catherine L. Ward, Jamie M. Lachman, Heather M. Foran, Marija Raleva, Adriana Baban and Nina Heinrichs in Violence Against Women

Supplemental material, sj-docx-1-vaw-10.1177_10778012231188090 for Co-Occurrence of Intimate Partner Violence Against Mothers and Maltreatment of Their Children With Behavioral Problems in Eastern Europe by Antonia Brühl, Catherine L. Ward, Jamie M. Lachman, Heather M. Foran, Marija Raleva, Adriana Baban and Nina Heinrichs in Violence Against Women

This is a randomized controlled trial (RCT) of an adapted parenting intervention, Parenting for Lifelong Health for Young Children aged 2-9 years old (PLH for Young Children Thailand), for low-income families in Udon Thani, Thailand. This study builds on a formative evaluation (OxTREC ref: 522-17), which focused on the cultural and contextual adaptation of the parenting intervention PLH for Young Children.

The Scale-Up of Parenting Evaluation Research Study is designed to study the dissemination and scale-up of the suite of Parenting for Lifelong Health programmes for families with young children and adolescents. For more, see https://www.spi.ox.ac.uk/parenting-for-lifelong-health-SUPER and https://www.who.int/violence_injury_prevention/violence/child/plh/en/ This is a page with our research tools. If you have questions or find any of the materials useful, we would love to hear from you! You can contact us at parentinglh@gmail.com

Funder: Edinburgh Centre for Data, Culture and Society, BACKGROUND: This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs). METHODS: A total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed. RESULTS: Three high-risk classes and one low-risk class emerged: (1) highly maltreated (7%, n = 89), (2) emotionally and physically abused with intra-familial violence exposure (13%, n = 152), (3), emotionally abused (40%, n = 474), and (4) low household dysfunction and abuse (40%, n = 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in the highly maltreated and emotionally abused classes compared with the low household dysfunction and abuse class. Additionally, the emotionally and physically abused with intra-familial violence exposure class had higher probability of low birthweight than the three remaining classes. CONCLUSION: Our results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.

Supplemental Material, sj-pdf-3-tva-10.1177_1524838020967340 for Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence by Karen R. Quail and Catherine L. Ward in Trauma, Violence, & Abuse

Additional file 1: Table S1. Instruments used, questions, and response categories. Table S2. Demographic characteristics of the sample from the Evidence for Better Lives Study (n = 1 189). Table S3. Adverse childhood experiences item endorsement frequencies and relative frequencies. Table S4. Class counts and proportions for the latent classes based on their most likely latent class membership.

Supplemental Material, sj-pdf-1-tva-10.1177_1524838020967340 for Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence by Karen R. Quail and Catherine L. Ward in Trauma, Violence, & Abuse

Supplemental Material, sj-pdf-8-tva-10.1177_1524838020967340 for Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence by Karen R. Quail and Catherine L. Ward in Trauma, Violence, & Abuse

Supplemental material, sj-docx-1-jad-10.1177_10870547221105064 for Associations Between ADHD Symptoms and Maternal and Birth Outcomes: An Exploratory Analysis in a Multi-Country Cohort of Expectant Mothers by Aja Louise Murray, Diana Taut, Adriana Baban, Chad Lance Hemady, Susan Walker, Joseph Osafo, Siham Sikander, Mark Tomlinson, Stefani Du Toit, Marguerite Marlow, Catherine L. Ward, Asvini Fernando, Bernadette Madrid, Vo Van Thang, Hoang Dinh Tuyen, Michael Dunne, Claire Hughes, Pasco Fearon, Sara Valdebenito and Manuel Eisner in Journal of Attention Disorders

Post-Survey instrument, Supplemental Table 1.A-D, Faculty Report instrument questions and data

Supplemental Material, sj-pdf-4-tva-10.1177_1524838020967340 for Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence by Karen R. Quail and Catherine L. Ward in Trauma, Violence, & Abuse

Supplemental material, sj-docx-1-jad-10.1177_10870547221105064 for Associations Between ADHD Symptoms and Maternal and Birth Outcomes: An Exploratory Analysis in a Multi-Country Cohort of Expectant Mothers by Aja Louise Murray, Diana Taut, Adriana Baban, Chad Lance Hemady, Susan Walker, Joseph Osafo, Siham Sikander, Mark Tomlinson, Stefani Du Toit, Marguerite Marlow, Catherine L. Ward, Asvini Fernando, Bernadette Madrid, Vo Van Thang, Hoang Dinh Tuyen, Michael Dunne, Claire Hughes, Pasco Fearon, Sara Valdebenito and Manuel Eisner in Journal of Attention Disorders

Supplemental Material, sj-pdf-9-tva-10.1177_1524838020967340 for Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence by Karen R. Quail and Catherine L. Ward in Trauma, Violence, & Abuse

This report details community profiles (snapshot) development for identified fishing communities in South Africa’s Western Cape. This forms part of research to establish a prototype set of social indicators relating to human wellbeing, social vulnerability and resilience in coastal communities of the Western Cape Province. Our work contributes to the H2020 TRIATLAS project that seeks to address gaps in understanding South and Tropical Atlantic marine ecosystems and predict their future evolution, thereby contributing towards sustainable management of these complex systems.

Supplemental Material, sj-pdf-7-tva-10.1177_1524838020967340 for Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence by Karen R. Quail and Catherine L. Ward in Trauma, Violence, & Abuse

Additional file 1. Overview of Parenting for Lifelong Health – Young Children adapted session content for Thailand. Table comparing original 12-session version content with the adapted 8-session version.

Additional file 2. Reliability of outcome instruments using pooled imputed datasets. Table with Cronbach’s alpha values for each outcome instrument.

Additional file 3. Complete case analyses. Outcomes at pre- and post-test for complete cases, and PDR assessment outcomes and comparisons at four time points for complete cases. Two tables with outcome data using complete case analysis.

Background This research prioritization aimed to identify major research gaps in mater-nal, newborn, child and adolescent health (MNCAH) to help mitigate the direct and indi-rect effects of the COVID-19 pandemic.Methods We adapted the Child Health and Nutrition Research Initiative methodology. Wedefined scope, domains, themes and scoring criteria. We approached diverse global expertsvia email to submit their research ideas in MNCAH and MNCAH-related cross-cutting/health systems area. We curated the research ideas as research questions (RQs) and sentthem to the consenting experts for scoring via the online link. For each RQ, the researchpriority score (RPS) was calculated as an average of individual criterion scores and rankedbased on RPS in each area.Results We identified top-ranked 10 RQs in each maternal, newborn, and child and ado-lescent health and 5 in the cross-cutting/health systems area. In maternal health, indirecteffects on care, measures to improve care, health risks and outcomes, and preventing andmanaging SARS-CoV-2 infection/COVID-19 disease were priority RQs. In newborn health,clinical characterization and managing SARS-CoV-2 infection/COVID-19 disease, mode oftransmission and interventions to prevent transmission were the focus. For child and ado-lescent health, top-ranked RQs were indirect effects on care, clinical status and outcomes,interventions to protect against SARS-CoV-2 infection/COVID-19 disease, and educationalinstitute-related RQs. The cross-cutting RQs were the effects of the pandemic on availabili-ty, access, care-seeking and utilization of MNCAH services and potential solutions.Conclusions We call on partners, including governments, non-governmental organizations,research institutes, and donors, to address this urgent research agenda.

Supplemental Material, Supplement_2_-_References_of_included_reviews for Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence by Karen R. Quail and Catherine L. Ward in Trauma, Violence, & Abuse

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Supplemental Material, Supplement_8_-_AMSTAR_tables for Nonviolent Discipline Options for Caregivers and Teachers: A Systematic Overview of the Evidence by Karen R. Quail and Catherine L. Ward in Trauma, Violence, & Abuse

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Diabetes increases the risk for cognitive impairment and doubles the rate of cognitive decline after diagnosis. In turn, cognitive dysfunction makes diabetes self-management more difficult. Nurses who help manage these conditions are focused on identifying patients at risk for complications, promoting symptom management, and preventing further decline. The purpose of the current study was to develop and pilot test a nurse-led comprehensive cognitive training intervention for individuals with type 2 diabetes mellitus (T2DM), the Memory Attention and Problem Solving Skills in Persons With Diabetes Mellitus (MAPSS-DM). The 8-week intervention combined in-person classes and online computer training. Development included: (a) adaptation of established, tested interventions; (b) interviews with stakeholders; (c) integration of course content; and (d) pilot testing of the intervention in a one-group, pre-/posttest design (N = 19). Postintervention scores improved in all areas; improvements were statistically significant for diet adherence (t[18] = -2.41, p0.005), memory ability (t[18] = 5.54, p0.01), and executive function (t[18] = 3.11, p0.01). Fifty-eight percent of participants stated the intervention helped their diabetes self-management, and 74% indicated they wanted to continue using cognitive strategies learned in the intervention. Results from this study showed the MAPSS-DM to be a promising cognitive training intervention for individuals with T2DM.Individuals with T2DM.In-person classes and online computer training of a cognitive training intervention.Participants who completed the intervention would show improved cognitive function, which would result in improved self-management adherence followed by better glycemic control.Improved diabetes self-management and sustained use of learned cognitive strategies. [Res Gerontol Nurs. 2019; 12(4):203-212.].

Esta investigación tuvo objetivo general determinar la relación entre la regulación emocional y los estilos de aprendizaje VAK en estudiantes del cuarto grado de primaria del Liceo Naval Manuel Clavero Muga – Ventanilla, 2018. El método utilizado fue el hipotético – deductivo. El tipo de estudio fue básico, de enfoque cuantitativo y diseño no experimental. La muestra fue de tipo censal y estuvo conformada por 128 estudiantes del cuarto grado de primaria del Liceo Naval Manuel Clavero Muga – Ventanilla, distribuidos en las secciones A, B, C y D. Los cuestionarios utilizados fueron adaptados de los instrumentos creados por Maqueira (2007) quien diseño un inventario sobre regulación de emociones y Cazau (2007) que elaboro un cuestionario sobre estilos de aprendizaje VAK Ambos instrumentos fueron validados y sometidos a la prueba de confiabilidad de alfa de Cronbach. Los datos recolectados se procesaron estadísticamente y los resultados se organizaron en tablas y gráficos que detallan los porcentajes y frecuencias de cada variable y sus dimensiones. Las hipótesis se comprobaron aplicando el coeficiente de correlación de Spearman. Logrando obtener como conclusión que: existe relación significativa entre la regulación emocional y los estilos de aprendizaje VAK en estudiantes del cuarto grado de primaria del Liceo Naval Manuel Clavero Muga – Ventanilla, 2018. El coeficiente de correlación tiene un valor de Rho = ,912. Lima Norte Escuela de Posgrado Atención al Infante, Niño y Adolescente

Introduction Families in low-income and middle-income countries (LMICs) face multiple challenges (eg, poverty and adverse childhood experiences) that increase the risk for child mental health problems, while the context may provide them with few resources. Existing preventionoriented parenting programmes have been shown to be effective in reducing child behaviour problems and associated risk factors. This project has the overall goal of adapting, implementing and testing a parenting intervention in three Southeastern European LMIC and uses the Multiphase Optimisation Strategy and dimensions of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. It is implemented over three phases: (1) preparation, (2) optimisation and (3) evaluation. The preparation phase, the subject of this paper, involves the adaptation and feasibility piloting of the parenting programme. Methods and analysis This protocol describes the assessment of an evidence-informed indicated prevention programme for families with children aged 2–9 years (Parenting for Lifelong Health for Young Children) for implementation in FYR of Macedonia, Republic of Moldova and Romania. In this phase, officials, experts, parents and practitioners are interviewed to explore their views of suitability and needs for further adaptation. In addition, a small pre–post pilot study will test the feasibility of the programme and its implementation as well as the evaluation measures in the three countries with 40 families per country site (n=120). Quantitative data analysis will comprise a psychometric analysis of measures, testing pre–post differences using ANCOVA, χ2 tests and regression analysis. For qualitative data analysis, a thematic approach

No Abstract

Large scale shifts playing out on global climate levels are manifesting locally in the South Africa’s terrestrial and marine ecosystems, where it is difficult to predict how different habitats may respond to these changes in natural systems, particularly at local levels. For example, the highly complex nature of climate variability in the southern Cape and on the Agulhas Bank, coupled with the lack of long-term environmental monitoring data, has resulted in knowledge gaps on how climate impacts these local social-ecological systems. This thesis focuses on bringing together knowledge systems from farmers, handline fishers and local scientific weather sources to examine climate variability in terrestrial and marine social-ecological systems of the southern Cape, in order to bring local perspectives into conversation with scientific data outputs. Through examining different knowledge systems in parallel and overlaying different perspectives and observations, this thesis contributes towards a better understanding of complex systems change, linked through the common thread of climate variability under a resilience lens, at the local scale of the southern Cape and Agulhas Bank. This thesis also contextualises responses to change under the theme of climate variability from farmers’ and fishers’ perspectives, and shows how different theoretical discourses can work in a complementary fashion to address complexity. The terrestrial component of this thesis examined local agricultural perspectives by surveying southern Cape farmers, and built in terrestrial scientific data through looking at local climate in relation to farming perspectives. Observations on terrestrial rainfall and temperatures were collected through interviews with 50 farmers, along with shared rainfall records from 13 farming families and ten official weather stations in the area. Fisher perspectives in relation to climate variability were then integrated with marine scientific data to examine the marine component of the Agulhas Bank. Fisher observations of climate variability were examined by drawing on existing research conducted through the South Coast Interdisciplinary Research Project. Marine wind data were obtained through model outputs from NCEP-DOE Reanalysis and a recent scatterometer-based product. Overlaying these different bodies of knowledge reduced the uncertainties associated with any single set of observations and confirmed two environmental regime shifts in the region, in the mid-1990s and end-2000s. Local climate knowledge of farmers and fishers also overlapped and corroborated these environmental regime shifts. Changes in prevailing wind direction, rather than wind speed, were more prominent over time. While no clear trends of change over time were found in rainfall and temperature time series, decadal variability was present and after the mid-2000s, the onset of seasonal autumn rainfall was found to have shifted to a month later. Knowledge disconnects were broadly related to scale mismatches between fisher observations and marine data tendencies; complexities around freshwater availability; and shifting baselines of natural resources concerning present versus past variability observed by farmers and fishers. Responses to climate variability were complex and other stressors associated with economic and political challenges were usually seen as a greater threat to local livelihoods. However, climate stressors can push social-ecological systems into vulnerable states if not well integrated into adaptation strategies, which can have serious implications for future food and job security in the southern Cape. Local-based case studies such as this one increase understanding of local social-ecological systems under global change in an effort to contribute to future adaptation strategies in the southern Cape region.

The Optimus Study South Africa[1] provides nationally representative data on the extent and impact of child sexual abuse in South Africa (SA). In this study, 9 717 adolescents (ages 15 - 17 years) were recruited nationally from schools (n=4 086) and households (n=5 631). The definition of sexual abuse used in the study was highly inclusive, including both the range of abuses defined in existing sexual offences laws and those children and adolescents have identified to be sexually intimidating, abusive or exploitative in previous studies (e.g. being forced to view pornography). The Optimus Study SA shows that sexual abuse of children and adolescents is widespread: 36.8% of boys and 33.9% of girls reported some form of sexual abuse. That is, overall, 35.4% – one in every three adolescents – reported having experienced some form of sexual abuse at some point in their lives. There were some differences by location and method of data collection, suggesting that the highest disclosure rates (particularly from boys) were obtained from self-completed questionnaires collected in schools. All the children were interviewed and given the opportunity to complete a confidential questionnaire on their own. Of the 4 086 young people interviewed in schools, 16.8% reported experiencing some form of sexual abuse. However, of those same young people who filled out a questionnaire themselves, 35.4% (or 1 399 children and adolescents) reported some form of sexual abuse. Only the household survey allowed us to estimate back to the population. Of the young people interviewed in the household survey, 14.6% reported some form of sexual abuse; in the general population of adolescents between the ages of 15 and 17, this means that an estimated 454 051 have experienced some form of sexual abuse. In the self-completed questionnaire in households, 26.3% (or 784 967 of the youth population) reported experiencing some form of abuse.

In the effort to address behavioural risk factors – which contribute significantly to the global burden of disease – there is a growing movement in public health towards the use of interventions informed by behavioural science. These interventions have the benefit of being amenable to testing in randomised controlled trials, are cost-effective, and when scaled up can have significant public health benefits. Given the substantial, and seemingly intractable, public health crises which South Africa faces, these interventions have significant potential in this context. A subset of these interventions attempt to change behaviour by shifting social norms perception (what I think everyone else does and thinks). This paper surveys the work on social norms intervention and considers its applicability to issues of public health in South Africa. Publisher PDF

The study is aimed at investigating understanding emotions in relation to aspects of antisocial behavior and substance use with respect to parenting styles. The sample were 397 early adolescents from two countries (Slovakia and South Africa). We examined if similarities or differences existed when comparing both national groups. A number of research studies document that antisocial behavior (e. g. bullying) is connected to the attitudes towards antisocial behavior so that specific attitudes predicted bullying behavior and other phenomena such as school and academic performance. The necessity of investigating the field of antisocial behavior and its moderators (such as parenting styles and emotional competencies) is not based only on prevalence rates of different types of antiso cial behavior during early adolescence, but also on the fact that risk behavior, in general, is directly or indirectly involved with health, well-being, school success and healthy development of personality. Currently, most scientific research on emotional intelligence focused more on emotional intelligence from the perspective of a trait (emotional self-efficacy), so the purpose of this study was to shed light more on the ability concept of emotional intelligence. We focused on one particular skill of emotional intelligence; understanding of emotions, as this ability forms the basic skills of emotional intelligence. The majority of the studies of early adolescent emotional intelligence skills have been conducted in Western societies, but processes underlyin g the formation of behavior and ability emotional intelligence factors and their manifestations may differ across cultures. There is an obvious influence of tradition, culture, ethnicity and society on the experience and expression of emotions, strategies for dealing with stressful situations, and behavior itself. Our study tries therefore to fill the gap in the literature by investigating the relationships between the ability to understand emotions as an emotional intelligence skill and antisocial behavior in early adolescents from very different countries; namely South Africa and Slovakia. Two groups were studied – one in Bratislava, Slovakia (Eastern Europe), and the other in Cape Town, South Africa. In Slovakia, all 6th graders from five state primary s chools that agreed to participate were approached for research matters. From that group, 155 learners were enrolled in study. The average age of this sample was 12.09 (SD 0.75). In South Africa, 242 students were chosen from three state schools which agreed to participate. The mean age of these students was 11.21 (SD=0.62). The schools were picked from different areas of Cape Town so that different ethnic groups were represented in the sample. All 6th grade students in the selected schools of Cape Town and Bratislava (N=397) were invited to participate, and were allowed to do so if their parents provided written consent and they themselves provided written assent. To measure the emotion understanding as a component of emotional intelligence, a performance test – Situational Test of Emotional Understanding (STEU, MacCann & Roberts, 2008) was used. The STEU is based on Roseman’s model of the emotions system. According to this model, the 17 most common emotions can be explained by a combination of seven appra isal dimensions. Antisocial and risk behavior and attitudes towards antisocial behavior were measured using subscales taken from The Social and Health Assessment Questionnaire (SAHA, Ruchkin, Schwab-Stone & Vermeiren, 2004). For our research purpose we selected several subscales: school attachment, academic motivation, affiliation with delinquent peers, victimization, parenting scales (inconsistent parenting, parental involvement, parental supervision, parental warmth), prosocial beliefs, alcohol use, substance use, cigarette use, antisocial behavior scales (conduct problem, less severe delinquency, severe antisocial behavior, legal consequences), beliefs legitimizing aggression, “hard to say no” scale and expectations about the future. Our study is focused on exploring associations between attitudes towards antisocial behavior, emotion understanding and parenting styles. According to the existing research it was possible to hypothesize: 1. There is a link between higher level of ability to understand emotions with less frequency of involvement in antisocial behavior as well as stronger attitudes against participation in antisocial behavior. 2. The parenting styles including parental involvement, supervision and warmth are connected with less involvement in antisocial and risk behavior. 3. Individuals with higher ability to understand emotions have a better parental background (especially warmth and involvement) in comparison with individuals with lower understanding of emotions. We applied exploratory analysis, calculating Spearman correlations and Mann-Whitney U-test in SPSS (since not all variables were normally distributed) and linear regression (in R) with quasi-poisson distribution, in order to examine associations between ability to understand emotions, antisocial behavior and other variables. A Generalized Linear Model UNIANOVA with quasi-poisson distribution was the most suitable for our data as they were not normally distributed, and did not fulfill the condition of the Poisson model (where mean must be equal to its variance). The analyses were conducted separately in samples of Slovak and South African early adolescents with regard to examining the relationships between key variables in both groups separately, and then to study the differences between them. The obtained results only partly support expected significant associations between higher level of emotion understanding and lower level of involvement in antisocial behavior. On the contrary the linkage between lower level of understanding of emotions and higher rate of negative forms of behavior was manifest. These relations were only evident with Slovak adolescents, but not with their South African counterparts. Findings also revealed the importance of parenting styles in different areas of early adolescent’s behavior. Parental involvement and warmth diminished the expressed involvement in antisocial behavior as well as substance use and increased pro-social beliefs. Regarding the method used to measure emotional intelligence, we conclude that the performance test of emotion understanding (STEU) is only partly a suitable tool for exploring this construct. First, the STEU – even though modified for this population – had some problems with internal consistency; and secondly, the degree to which these instruments serve as indicators of real life behavior is also questionable. Although our findings support only some relationships we expected to find, we believe that even these findings of associations of ability to understand emotions with some aspects of behavior and influence of parenting style in early adolescence could assist as baseline facts and offer new ideas and inspirational base for further research studies.

Representative image presenting selection of region for immunohistochemistry analysis. Quantitative analysis of CD4, CD8, and CD68 was conducted off of the whole bone section (A) by selecting the region of the callus (B). In all instances the callus region was traced in the area between the bone ends on the anterior aspect of the tibia without selection of mineralized bone or skeletal muscle fibers. C) The selected representative image corresponds to the image in Fig. 6 for reference. (PDF 3305Â kb)

Children living in low- and middle-income countries, such as South Africa, face elevated risks of child maltreatment. Although evidence-based parenting programs have been shown to reduce rates of abuse in high-income countries, few studies have examined their effectiveness in low- and middle-income countries. Moreover, local cultural contexts may require the adaptation of evidence-based approaches in order to assure program acceptability and effectiveness. This study focused on the systematic development of an evidence-informed, locally relevant parenting program for socioeconomically disadvantaged families with parents of children aged 3–8 years, in Cape Town, South Africa. Intervention development took place over three stages: (a) identification of common core intervention components in evidence-based parenting programs (b) formative evaluation using qualitative in-depth interviews and semi-structured focus groups with local practitioners and low-income parents, and (c) development of intervention structure, format, and protocols. The process resulted in a manualized, group-based, 12-session parenting program that integrated existing evidence of effective components within a local, culturally relevant context. Recommended next steps are rigorous piloting to test feasibility and preliminary intervention effects followed by experimental trials to examine intervention effectiveness in a real-world setting.

Background No known studies have tested the effectiveness of child abuse prevention programmes for adolescents in low- or middle-income countries. ‘Parenting for Lifelong Health’ (http://tiny.cc/whoPLH) is a collaborative project to develop and rigorously test abuse-prevention parenting programmes for free use in low-resource contexts. Research aims of this first pre-post trial in South Africa were: i) to identify indicative effects of the programme on child abuse and related outcomes; ii) to investigate programme safety for testing in a future randomised trial, and iii) to identify potential adaptations. Methods Two hundred thirty participants (adolescents and their primary caregivers) were recruited from schools, welfare services and community-sampling in rural, high-poverty South Africa (no exclusion criteria). All participated in a 12-week parenting programme, implemented by local NGO childcare workers to ensure real-world external validity. Standardised pre-post measures with adolescents and caregivers were used, and paired t-tests were conducted for primary outcomes: abuse (physical, emotional abuse and neglect), adolescent behaviour problems and parenting (positive and involved parenting, poor monitoring and inconsistent discipline), and secondary outcomes: mental health, social support and substance use. Results Participants reported high levels of socio-economic deprivation, e.g. 60 % of adolescents had either an HIV-positive caregiver or were orphaned by AIDS, and 50 % of caregivers experienced intimate partner violence. i) indicative effects: Primary outcomes comparing pre-test and post-test assessments showed reductions reported by adolescents and caregivers in child abuse (adolescent report 63.0 % pre-test to 29.5 % post-test, caregiver report 75.5 % pre-test to 36.5 % post-test, both p

The World Health Organization (WHO), the United Nations Development Programme and the United Nations Office on Drugs and Crime jointly released the first Global Status Report on Violence Prevention[1] on 10 December 2014. The report reviews how governments around the world, including in South Africa (SA), are attempting to curb interpersonal violence. There is some good news in the report. In common with many other countries, SA’s homicide rate has declined over the past decade: it was 40.3/100 000 in 2004/5, and 32.2/100 000 in 2012/2013.[2] Across the five types of interpersonal violence assessed in the report – child maltreatment, youth violence, intimate partner violence, sexual violence and elder abuse – SA has national action plans for all but two, namely youth violence and elder abuse (and in these two cases, some provinces have action plans). But manifestly it is not all good news. Homicide levels in SA are fluctuating around 32/100 000, and over the past 4 years, the lowest level achieved was 30.9/100 000 (in 2011/2012).[2] Homicide is a robust indicator of the prevalence of other forms of violence,[3,4] so this demonstrates that SA is struggling to reduce violence below the horizon achieved in 2011/2012. That rate is in itself exceedingly high: in 2012, the African Region as a whole had a rate of 10.9/100 000, making SA one of the most lethally violent African countries for which data are available.[1].

Globally, randomised controlled trials (RCTs) are increasingly seen as the gold standard of programme evaluation, representing the best way to determine whether new interventions are effective – but they are not without limitations. In this article, we discuss the phases of scientific discovery and the research standards that are necessary before scaling up interventions. We also outline the core characteristics of RCTs, such as randomisation, efficacy and effectiveness, and discuss the benefits of using the RCT as the standard of intervention evaluation. We discuss how ‘realist’ evaluation contributes to what policymakers need to know in order to make a decision about an evaluation and alternatives to the RCT, such as stepped wedge, regression discontinuity, non-randomised cohort, and time series designs.

This study evaluated a South African outpatient drug counselling centre’s motivational interviewing-based treatment programme from theory and outcomes-based perspectives. 142 participants were interviewed at admission to the programme and followed up 6 and 10 weeks later. Trajectories of substance use, substance dependence, self-efficacy, motivation (using SOCRATES sub-scales of Problem Recognition, Ambivalence and Taking Steps) and NA/AA affiliation were examined. Self-efficacy and SOCRATES Taking Steps scores increased and were significantly associated with substance use levels, which decreased significantly over time. Higher self–efficacy scores at end-of-treatment (6 weeks) predicted lower substance use scores at 10 weeks. More programme attendance was associated with lower levels of substance use/dependence. Abstinence was achieved by 47% of participants.Keywords: substance abuse, substance dependence, treatment outcomes, self-efficacy, motivation, evaluation

FUsed in Sarcoma/Translocated in LipoSarcoma (FUS/TLS or FUS) has been linked to several biological processes involving DNA and RNA processing, and has been associated with multiple diseases, including myxoid liposarcoma and amyotrophic lateral sclerosis (ALS). ALS-associated mutations cause FUS to associate with stalled translational complexes called stress granules under conditions of stress. However, little is known regarding the normal role of endogenous (non-disease linked) FUS in cellular stress response. Here, we demonstrate that endogenous FUS exerts a robust response to hyperosmolar stress induced by sorbitol. Hyperosmolar stress causes an immediate re-distribution of nuclear FUS to the cytoplasm, where it incorporates into stress granules. The redistribution of FUS to the cytoplasm is modulated by methyltransferase activity, whereas the inhibition of methyltransferase activity does not affect the incorporation of FUS into stress granules. The response to hyperosmolar stress is specific, since endogenous FUS does not redistribute to the cytoplasm in response to sodium arsenite, hydrogen peroxide, thapsigargin, or heat shock, all of which induce stress granule assembly. Intriguingly, cells with reduced expression of FUS exhibit a loss of cell viability in response to sorbitol, indicating a prosurvival role for endogenous FUS in the cellular response to hyperosmolar stress.

Insect-borne diseases kill millions of people annually. One strategy for controlling transmission of insect-borne disease involves replacing the native insect population with transgenic animals unable to transmit disease. Population replacement requires a drive mechanism to ensure the rapid spread of linked transgenes conferring disease refractoriness. Medea selfish genetic elements have the feature that when present in a female, only offspring that inherit the element survive, a behavior that can lead to spread. Here we use modeling to identify conditions under which Medea elements spread. We derive equations describing the allele frequencies required for spread of Medea elements with a fitness cost, and the equilibrium allele frequencies attained. We validate our model against a synthetic Medea element created in Drosophila and find that the model fits the data without parameter fitting. We show that when Medea spreads, it drives the non-Medea genotype out of the population, and we provide estimates of the number of generations required to achieve this goal. We also characterize two contexts in which Medea elements with fitness costs drive the non-Medea allele from the population: an autosomal element in which zygotic rescue is incomplete and an X-linked element in species in which X/Y individuals are male. Finally, we explore costs and benefits associated with the introduction of multiple Medea elements. Our results suggest that Medea elements can drive population replacement under a wide range of conditions, potentially reducing disease burden.

One strategy for controlling transmission of insect-borne disease involves replacing the native insect population with transgenic animals unable to transmit disease. Population replacement requires a drive mechanism to ensure the rapid spread of linked transgenes, the presence of which may result in a fitness cost to carriers. Medea selfish genetic elements have the feature that when present in a female, only offspring that inherit the element survive, a behavior that can lead to spread. Here, we derive equations that describe the conditions under which Medea elements with a fitness cost will spread, and the equilibrium allele frequencies are achieved. Of particular importance, we show that whenever Medea spreads, the non-Medea genotype is driven out of the population, and we estimate the number of generations required to achieve this goal for Medea elements with different fitness costs and male-only introduction frequencies. Finally, we characterize two contexts in which Medea elements with fitness costs drive the non-Medea allele from the population: an autosomal element in which not all Medea-bearing progeny of a Medea-bearing mother survive, and an X-linked element in species in which X/Y individuals are male. Our results suggest that Medea elements can drive population replacement under a wide range of conditions.

To investigate the prevalence and correlates of missed opportunities for addressing reproductive and mental health needs during patients' visits to primary healthcare facilities.We selected a random sample of participants from 14 of the 49 clinics in Cape Town's public health sector using stratified, cluster random sampling (n = 2618). Participants were screened to identify those at risk for unsafe sexual behaviour and a mental disorder (specifically substance use, depression, anxiety, and suicide). Information pertaining to whether or not respondents were asked about these issues during clinic visits during the previous year was elicited. The rates and correlates of missed opportunities for providing reproductive and mental health interventions were calculated.The criteria of a strict definition of a missed opportunity for reproductive or mental health care information were fulfilled by 25% of the sample, while 46% met criteria for a looser definition. After adjusting for the effects of other variables in the model, men and Coloured respondents were more likely to have satisfied the definition of a missed opportunity for an intervention, while having completed high school and having children increased the likelihood of receiving an intervention.Consultations with primary healthcare providers in which these issues are not discussed may represent missed opportunities. Persons presenting for routine care can be counselled, screened and, if required, treated. Interventions are needed at the patient, provider, and community levels to increase the opportunities to provide reproductive and mental health care to patients during routine visits.

One proposed strategy for controlling the transmission of insect-borne pathogens uses a drive mechanism to ensure the rapid spread of transgenes conferring disease refractoriness throughout wild populations. Here, we report the creation of maternal-effect selfish genetic elements in Drosophila that drive population replacement and are resistant to recombination-mediated dissociation of drive and disease refractoriness functions. These selfish elements use microRNA-mediated silencing of a maternally expressed gene essential for embryogenesis, which is coupled with early zygotic expression of a rescuing transgene.

Objectives. To document and compare prevalence rates of adolescent injury-related risk behaviours at six sites in South Africa. Design. The identical self-administered instrument was used at all sites. Prevalence rates (with 95% confidence intervals) were calculated taking the multistage cluster sampling strategy into account. Setting and subjects. In Cape Town, Durban, Port Elizabeth and Mankweng participants were drawn from either grades 8 or 9, and grade 11, while in Queenstown and Umtata they were drawn from grade 11 only. We selected 39 schools in Cape Town and Durban, 33 in Port Elizabeth and 20 in each of the rural areas. Outcome measures. Road-related risk behaviour, violence, and suicide attempts. Results. Across the sites there were high rates of risk behaviour in all domains. For example, in the 12 months preceding the survey an estimated 52.8% of grade 11 males in Cape Town had travelled in the front seat of a motor vehicle without a seatbelt, 33.0% of grade 8 males in Mankweng had bullied others, while 44.5% of the same group had been bullied, and 18.6% of females in Port Elizabeth had attempted suicide. Rates were lower in rural areas for behaviour involving motor vehicles, but there were no consistent urban-rural findings for violence-related behaviour. Females were at higher risk of suicidal behaviour and males were at higher risk of other injury-related behaviour. Conclusions. There is a need for effective interventions to reduce the extent of injury-related risk behaviour in adolescents in urban and rural settings. S Afr Med J 2006; 96: 825-830.