Search

Problem-solving and enquiry-based learning are integral in the Mathematics and Science curriculum in South Africa through online-based assessment. Online assessment has rapidly gained recognition because of technology. In this paper, the authors explored the views of online baseline assessment among Senior Phase First-year Mathematics Student Teachers. The researchers adopted a qualitative research method. Data was collected from the participants using an online Google form developed into a questionnaire. The participants in this study were first-year students enrolled for the Bachelor of Education in Mathematics at a university in a rural province of South Africa. The first-year student teachers were exposed to the senior phase baseline assessments through the licensed online Computer Aided Mathematics Instruction (CAMI) tool. One hundred and sixteen (116) senior-phase student teachers completed the online questionnaire. This study used convenience sampling since it was the most appropriate method to conveniently invite the participant. The findings revealed that first-year student teachers were enthusiastic and motivated to write the baseline assessment on computers for the first time. The result also showed that several first-year student teachers experienced difficulties solving mathematics problems using computers. This study recommends more intensive research on student teachers' views on online assessment regarding gender and time.

Background: The presence of African women in mathematics has been nearly invisible. The underrepresentation of African women in this field is a result of their historical socio-political marginalisation. The mathematics discipline is politicised, racialised, and gendered to systematically oppress African women. The mathematics fields continue to be a masculine and white male dominated field, which reinforces and preserves masculine culture which is hostile and unwelcoming to women. African women mathematicians are further oppressed because of their racial and gendered identities in fields that are ideologically founded on proving the racial, gendered, social, cultural, and intellectual inferiority of Africans. Aim: The article aims to exemplify the lived experiences of African women doctoral students in the mathematics disciplines in South African universities. The article critically interrogates the factors that influence the participation, progression, and retention of African female doctoral students in the mathematics disciplines. Setting: The article comes from a larger study which investigated the reasons why African doctorate students do not become academics after they receive their doctorates in science, technology, engineering and mathematics (STEM) disciplines in South African universities. This paper focuses on the experiences of 10 African female doctoral students at five universities in South Africa. The universities were selected because they ranked in the top five in South Africa. Two of the institutions are historically Black universities and the rest are historically white institutions, with one historically Afrikaner-speaking university--between 2019--2021. Methods: This article employed a qualitative research methodology, where semi-structures interviews were conducted with 10 African female doctoral participants in mathematics disciplines in five South African universities and is underpinned by the theory of intersectionality. Results: The findings reveal how interlocking systems of oppression continue to influence the recruitment, retention, and progression of women in the mathematics discipline, thereby providing insight into the mechanisms that need to be altered and/or put in place to actively recruit African female doctoral students and retain them in academic positions. Conclusion: The article concludes that despite the mathematics field proclaiming neutrality and objectivity nevertheless, African women still experience racism, sexism, and classism. The experiences of African women in mathematics are vital to understanding the reasons why there is a high attrition rate of African women in the mathematics discipline in academia and why they do not become academics when they could transform this discipline.

Learners' participation in mathematics decreases during their transition from primary to high school. This is despite adolescents' cognitive growth equipping them with enhanced cognitive ability; to learn mathematics. Hence low participation in mathematics does not result from cognitive deficiency. Rather, lack of motivation to learn mathematics may be the factor. According to self-determination theory, motivation results from nurturing three human basic needs: autonomy, connectedness and competence. Since identity is linked to autonomy, identities in mathematics learning impacts motivation to learn the subject. Hence, this paper reports on the action research intervention which took advantage of adolescents' preoccupation with identity formation. In line with continuous cycles of action research, the intervention is the pilot of the ongoing study that seeks to enhance mathematics learning by utilizing non-cognitive factors that resonate with the characteristics of adolescents. The paper reports on how the autonomy to form their identities in mathematics learning, impacted the adolescents' learning and attitude towards mathematics. Qualitative results show that learners lived up to their self-formed identities and this enhanced their motivation to learn mathematics. Further studies that forge positive identities in mathematics classrooms to enhance motivation to learn mathematics are recommended.

This paper reports on an exploration of students' learning derived from the implementation of learning materials developed in a previous collaborative project. The purpose of the study was to examine the development of third-year students' understanding of the Reimann Sum. These concepts were taught to undergraduate teacher trainees wishing to specialize in the teaching of mathematics in the FET (further education and training) school curriculum. The learning materials were developed by mathematics teacher educationists from the University of Witwatersrand, the UKZN (University of KwaZulu-Natal) and the Nelson Mandela Metropolitan University. A group of 31 students participated in the project. The study adopted the APOS (action-process-object-schema) approach within constructivism, as a theoretical framework. Data were generated from students' responses to the collaborative tasks. A genetic decomposition of the Reimann Sum is offered and used as a basis for the analysis. This paper, specifically, reports on the investigation of students' responses based on a learning theory within the context of advanced mathematical thinking and makes a contribution to an understanding of how these students constructed the concepts in a collaborative way. Appended is "The Worksheet with Instructional Tasks." (Contains 5 tables.)

Pre-service secondary mathematics teachers have a poor command of the exact language of mathematics as evidenced in assignments, micro-lessons and practicums. The unrelenting notorious annual South African National Senior Certificate outcomes in mathematics and the recognition by the Department of Basic Education (DBE) that the correct use of mathematical language in classrooms is problematic is reported in the National Senior Certificate Diagnostic Reports on learner performance (DBE, 2008-2013). The reports further recognise that learners do not engage successfully with mathematical problems that require conceptual understanding. This paper therefore highlights a need for teachers to be taught and master an exact mathematical language that for example, calls an "expression" an "expression" and not an "equation". It must support the call of the DBE to use correct mathematical language that will support and improve conceptual understanding rather than perpetuate rote procedural skills, which are often devoid of thought and reason. The authentic language of mathematics can initiate and promote meaningful mathematical dialogue. Initial teacher education programmes, as in the subject methodologies, affords lecturers this opportunity. The language notions of Vygotskian thought and language, Freirian emancipatory critical consciousness and Habermasian ethical and moral communicative action frame the paper theoretically. Using a grounded approach, after examining examples of student language in a practice based research intervention, the design and development of a repertoire of language categories, literal, algebraic, graphical (Cartesian) and procedural (algorithmic) emerged from three one-year cycles of an action research methodology. The development of these repertoires of language was to assist teachers in communicating about mathematical objects through providing a structured framework within which to think and teach. A course model encompassing small group discussions, an oral examination and a self-study action research project, that helped sustain the teaching of an exact mathematical language, is presented. This is supported by student reflections on the usefulness of implementing them.

This paper reports on the findings of a baseline study that fed on to a broader investigation exploring ICT integration in the teaching of functions. The baseline study was premised on the observation that the notion of function, despite being a fundamental and central idea in the mathematics school curriculum, presents pedagogical challenges to both teachers and learners. The study used the qualitative case study design to investigate Grade 11 mathematics learners' errors and misconceptions under hyperbolic functions at a rural high school in the Limpopo province of South Africa. Informed by the constructivist APOS theory conception levels, learners' errors were detected from their written responses in a diagnostic test. The learners were then individually interviewed during task-based interviews to infer on the misconceptions underlying their errors. Qualitative analysis of the data revealed the following categories of misconceptions: algebraic, conceptual, asymptotic, graphical, and notational misconceptions. The study established that errors, if diagnosed and corrected, are springboards and milestones to the formulation and construction of proper mathematical ideas. To resolve learners' misconceptions, this study recommends that teachers should use explorative and discovery pedagogical strategies to enable learners realize their own misconceptions and self-correct. Based on the findings of this study, the integration of Information and Communication Technologies (ICTs) in teaching functions as an intervention strategy will be explored.

In this paper, I argue that the establishment of after-school mathematics clubs in early grades holds rich potential for supporting the development of increasingly participatory and sensemaking maths learning dispositions. Within the South African Numeracy Chair project, lead by the author, multiple after-school mathematics clubs have been set up for learners in Grades 3-6 across Eastern Cape schools. These clubs are a complementary initiative to teacher development, aimed at improving low levels of numeracy learning across the majority of schools in the province. Two sources of data, learner interviews and teacher questionnaires, from one case study club, are shared in this article to illuminate the potential such clubs hold in developing increasingly participatory mathematics learning dispositions.

It is argued in this paper that there is an absence of literature relating to research on learner mathematical dispositions, particularly with young learners. Drawing on Kilpatrick, Swafford and Findell's (2001) five interrelated strands of mathematical proficiency, which include: conceptual understanding, procedural fluency, strategic competence, adaptive reasoning and productive disposition, it is argued that there has been little engagement with productive disposition in the field of mathematics education and how we might access and assess this strand. Despite competence in all strands being essential for mathematical proficiency, literature and assessments that seek to establish learner levels of mathematical proficiency have tended to focus on the first four and have neglected the last; productive disposition. Finding ways in which to access student mathematical learning dispositions can be challenging, especially with young learners who struggle to articulate their views. An instrument is shared that the author has designed with doctoral fellow, Debbie Stott, in order to access and assess the productive disposition of learners participating in maths clubs run within the South African Numeracy Chair. The findings that emerge in one Grade 3 club with six learners is shared. These findings are related to the data collected through instruments that assess the other four strands of mathematical proficiency. This enables a holistic picture of learner's mathematical proficiency as intended in the conceptualisation of the interrelated five strands of proficiency.

There is not just one mathematics taught at university level, nor is there one group of students. Mathematics is taught differently depending on the discipline and the perceived background of the student. There is engineering mathematics for the students heading towards engineering degrees, life science mathematics for those heading towards biology degrees and so on. This paper considers the phases of transitions that students experience as they embark on a course of study and then go on to professional life. We make inferences about the ways the curriculum should be designed to alleviate the difficulties of these phases as well as to take account of the capabilities that graduates will require in the workplace. It is not only where students are coming from that affects their learning but where they are heading to, in combination with their perceptions of that destination. (Contains 1 table and 1 figure.)

One challenge for an optimal design of the mathematical components in engineering education curricula is to understand how the procedural and conceptual dimensions of mathematical work can be matched with different demands and contexts from the education and practice of engineers. The focus in this paper is on how engineering students respond to the conceptual-procedural distinction, comparing performance and confidence between second and fourth year groups of students in their answers to a questionnaire comprising conceptually and procedurally focused mathematics problems. We also compare these students' conceptions on the role of conceptual and procedural mathematics problems within and outside their mathematics studies. Our data suggest that when mathematical knowledge is being recontextualised to engineering subjects or engineering design, a conceptual approach to mathematics is more essential than a procedural approach; working within the mathematical domain, however, the procedural aspects of mathematics are as essential as the conceptual aspects.

"Personal learning environments" (PLEs) and "personal learning networks" (PLNs) are well-known concepts. A personal learning network "cluster" is a small group of people who regularly interact academically and whose PLNs have a non-empty intersection that includes all the other members. At university level PLN clusters form spontaneously among students and are known to last over an extended period of time. Little is known regarding the workings of these PLN clusters of students. The claim is that these PLN clusters are at the heart of student learning and are aligned with the current trend of a knowledge-pull community of learning. In this paper we investigate the activities and characteristics of PLN clusters in two different fields of study at a South African university, namely mathematics and computer science. We discuss the benefits that these clusters offer, investigate the mashup of activities and tools and we contrast experiences in the two fields of study. It is the commonalities rather than differences that are striking between the two groups of students. Although computer science students lean more towards digital communication, both groups impress with the pride they take in their PLN clusters and are vocal in describing the benefits that these clusters offer.

In South Africa, there is no adequate research that explored mathematics learning and teaching within rural schools and classrooms. Various literature posits that mathematics education research has virtually over-concentrated on urban and township schools and consistently ignored rural contexts and schools. Arguments exist that rural education and rural education research have been understudied in South Africa. Presumably, this would include mathematics education research as well. This paper explores the relationship between witchcraft beliefs, which is considered as an entrenched cultural phenomenon, and learners' mathematics learning within rural classrooms. In this paper, the local influences include that the learners end up not demonstrating their full understanding of mathematics contents because of the beliefs that if they exhibit their knowledge of the subject, they may be bewitched. Cultural Relativism was used to theorise the study within qualitative critical phenomenology as a methodology for the study. The study comprises 12 mathematics learners from a rural Acornhoek region in Mpumalanga Province, and data were collected using individual semi-structured interviews while the collected data were analysed using Critical Discourse Analysis. Findings from this study illuminated that local beliefs and knowledge such as witchcraft exert significant influence on schools and learners' learning, including learners' not demonstrating their optimum understanding of mathematics. [ABSTRACT FROM AUTHOR]

Given the importance of mathematics performance of learners and the challenges in South Africa, it is important that the expertise of all role-players, including the subject advisors who visit the teachers to guide and support them, is used to its full potential. While some studies have explored the experiences of teachers in this regard, literature on the experiences of mathematics subject advisors is scant. Furthermore, little has been published on the experiences of subject advisors within the context of rural areas with a low population, such as the Northern Cape Province. This article addresses the gap by exploring the deeper understanding of mathematics subject advisors’ experiences when conducting school support visits. Taking a qualitative research approach, I conducted semi-structured interviews with six mathematics subject advisors from the four phases (foundation, intermediate, senior, and further education and training) in all five of the education districts of the Northern Cape Department of Education (Frances Baard; Z.F. Mgcwawu; Pixley Ka Seme; Namakwa; and J.T. Gaetsewe). Through Husserl’s phenomenological theoretical framework, complemented with Gibbs’ reflective cycle and Colaizzi’s seven steps of data analysis, participants were found to have had both good and bad experiences when conducting school support visits. Experiences included positive attitudes from educators and schools in general, and good curriculum implementation and teaching and learning practices. However, participants were sometimes received with hostility, and observed poor curriculum implementation and teaching and learning practices. Noteworthy is some negative union influence, lack of specialisation in mathematics by foundation phase departmental heads, lack of coherence in communication, and lack of cooperation and collaboration amongst district officials. If the concerns raised by mathematics subject advisors in this paper are not addressed, these may have a negative impact on the experiences of subject advisors and, by implication, on learner performance as well as education in general. [ABSTRACT FROM AUTHOR]

Mathematics is a core subject in South Africa. Studies have shown that the performance of learners on this subject is not encouraging. Many factors have been alluded to by scholars as contributing factors to this poor performance. The gap between theory and practice of mathematics teaching can be bridged by the use of appropriate learning styles, availability, and utilization of instructional. This paper finds out the relationship that exists among learning styles, instructional materials, and mathematics performance of Grade 6. The choice of Grade 6 is important because it is the last grade level of primary school before a learner can enter secondary school level in South Africa. The study adopted a correlational research design of a quantitative approach. Stratified sampling techniques were used to select 1225 learners from Grade 6 schools within Buffalo City Metropolitan Education District. The data revealed among others that in Buffalo City, availability and utilization of instructional materials have no significant relationship with the mathematics performance of selected grade 6 learners (B=.023, t=.804, P=0.05) while students learning styles (visual, auditory, and kinesthetic) have a significant relationship with grade 6 learners Mathematics performance (B=-.113, t=-3.886, p<0.05). The study concluded that one of the most fundamental issues to consider in improving Mathematics performance is the understanding of the learners' learning styles and effective use of appropriate instructional materials for teaching Mathematics. [ABSTRACT FROM AUTHOR]

TB is rated as one of the world’s deadliest diseases and South Africa ranks 9th out of the 22 countries with hardest hit of TB. Although many pieces of research have been carried out on this subject, this paper steps further by inculcating past knowledge into the model, using Bayesian approach with informative prior. Bayesian statistics approach is getting popular in data analyses. But, most applications of Bayesian inference technique are limited to situations of non-informative prior, where there is no solid external information about the distribution of the parameter of interest. The main aim of this study is to profile people living with TB in South Africa. In this paper, identical regression models are fitted for classical and Bayesian approach both with non-informative and informative prior, using South Africa General Household Survey (GHS) data for the year 2014. For the Bayesian model with informative prior, South Africa General Household Survey dataset for the year 2011 to 2013 are used to set up priors for the model 2014. [ABSTRACT FROM AUTHOR]

This paper examines whether tobacco expenditure leads to the crowding out or crowding in of different expenditure items in South Africa. We apply genetic matching to expenditure quartiles of the 2010/2011 South African Income and Expenditure Survey. Genetic matching is a more appealing approach for dealing with the endogeneity of tobacco expenditure that often plagues studies using systems of demand equations. Further, genetic matching provides transparent measures of covariate balance giving the analyst objective means of assessing match success. We find that the poorest tobacco consuming households in South Africa consistently allocate smaller budget shares towards food items than non-smoking households. Specifically, we find that dairy, fruits, nuts and oils are displaced in favour of tobacco expenditure in the two poorest quartiles. Unsurprisingly, food items are never displaced for households in the top two quartiles, given these households’ greater access to resources. Like other studies in the literature, we find that tobacco expenditure consistently crowds-in alcohol across all quartiles confirming the strong complementarities between the two. [ABSTRACT FROM AUTHOR]

Although buoyed by the induction of a democratic government, and the high ideals of our constitution, the South African education system has in many ways not met the expectations of its people, in this case, the mathematics education community. With the birth of an expansive intended curriculum came the monitoring of the outcomes through systemic type testing, the so-called attained curriculum. In time, it became clear that the inevitable 'teaching to the test' would constitute a narrowing of the implemented curriculum. Two possible constraining influences of the systemic test were identified, namely, a narrowing of the curriculum, and reliance on only one source of external monitoring. To counteract these, a project titled Assessment Enhanced Teaching and Learning (AETL) has been initiated, involving Grade Nine mathematics teachers. The aim of the project is to provide intermittent markers of progress to the teachers and learners at strategic points throughout the year. Teacher involvement in the design and implementation of these formative assessment tasks is thus central to the project. In this paper, we report on a case study at one school in the Pretoria region, and explore the use of structured assessment tasks as an approach to professional development. The question posed here is, "How does the implementation of strategically designed assessment tasks support professional development and enable professional agency?" Our findings indicate a strong sense of agency motivated by the need to excel in systemic type testing. [ABSTRACT FROM AUTHOR]

The study reported on here was conducted to explore four Grade 7 mathematics teachers' understanding of the relationship between the objectives indicated in the CAPS for teaching different topics/concepts and instructional time stipulated for doing so. Seven lessons were studied in 4 primary schools in the Vhembe district of the Limpopo province, South Africa. A constructivist philosophical approach was used. The data collection methods included interviews and classroom observations. The main finding indicates teachers' understanding of instructional time as either a regulatory or a teaching tool. The ability to translate instructional time into social time depends on the level of teachers' curriculum literacy. Consideration of how CAPS objectives could be fulfilled based on the topic/concept to be taught and the stipulated instructional time, influenced the learners' conceptual understanding, procedural fluency, and competency in mathematics. The conclusion underscores the importance of instructional time as both an essential authoritative regulatory tool and signal of a pedagogic device and communication required to advance the instructional objectives. [ABSTRACT FROM AUTHOR]

The introduction of progression policy, which prohibits the repetition of a grade to more than once within each of the four phases of Basic Education, was enforced in South Africa in the Further Education and Training phase in 2013, but appropriate strategies which could be applied to support progressed learners are not addressed. This research was qualitative by nature and approached according to the interpretative paradigm. It was a comparative case study, which investigated strategies to support Grade 12 progressed Mathematics learners using Information Communication Technologies in comparison with other strategies that do not apply ICT instructional technologies. Data collection strategies were semi-structured interviews, questionnaires and support policies. The study population was sixteen FET Mathematics educators from five schools in Ekurhuleni North district. The findings indicated that connectivism, when incorporated into teaching and learning, becomes an effective support tool for progressed learners. ICTs within networks makes teaching and learning more learner centred, improves participation, learner attainment and pass rate. Learners are able to learn at their own pace, in their most convenient set-up and they manage what they learn, how they learn, with whom they learn and what information they require. The study found that there are greater benefits of using ICT instructional technologies in a connectivist classroom to support progressed learners, but that traditional support strategies cannot be ruled out due to the socio-economic challenges schools under research experienced. The findings further indicated that there is a dire need of a comprehensive support policies, strategies and guidelines to support progressed and low-ability learners in Mathematics both digitally and non-digitally. [ABSTRACT FROM AUTHOR]

Can providing learner support materials, particularly custom-designed workbooks, improve primary mathematics achievement more cost effectively than providing conventional textbooks? To contribute to this debate, this paper reports on the findings of a study conducted in 201 Obya consortium of educational researchers at JET Education Services and University of the Witwatersrand. Between January and June 2010, the consortium undertook a randomised control trial of learning support materials in Grade 6 classes in 44 primary schools serving low income communities in Gauteng province. The study shows that Grade 6 learners exhibit the same degree of learning improvement in mathematics, whether they use a conventional textbook or a workbook specifically customised to address the problems exhibited by South African learners. From a policy perspective, no warrant can be issued on the relative effectiveness of the specific workbooks considered in the study. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the present study was to explore the relationship between satisfaction with life and mathematics achievement among a nationally representative sample of Grade 9 learners in South Africa. Methods: Using the Trends in Mathematics and Science Study (TIMSS 2019) based on a sample of 20,829 learners (females = 11,067 and males = 9,719), and employing structural equation modelling (SEM), we examined the nature of the relationship between satisfaction with life and mathematics achievement, considering the role of gender, parental involvement, and instructional clarity. Results: Our findings showed that satisfaction with life is positively related to mathematics achievement, but is not moderated by gender. Additionally, instructional clarity contributes to, and is a partial mediator of, the relationship between life satisfaction and mathematics achievement. This suggests that greater instructional clarity is positively associated with high achievement in mathematics, over and above the relationship with satisfaction with life. By contrast, parental involvement negatively mediates this relationship, suggesting that mathematics achievement is negatively associated with certain forms of parental involvement, such as setting time aside for homework; and checking if homework is done. Discussion: Given the tested linear relationship between life satisfaction, instructional clarity and mathematics achievement, the results of the study suggest that if wellbeing is improved and existing instructional practices are constantly reviewed, mathematics scores could be positively affected. In addition, the emerging finding on the negative role of parental involvement in the hypothesised mediated relationship suggests that learners could benefit from properly tailored, and governmentsponsored, afterschool tutoring. [ABSTRACT FROM AUTHOR]

Universal health coverage (UHC) aims to ensure people have access to the health services they need. Sixteen tracer indicators were developed for implementation by countries to measure UHC in the health system. South Africa uses 15 of the proposed 16 indicators. Operational managers in the public health care sector collect data and report on these indicators at a primary health clinic level. This qualitative study explored the knowledge and attitudes of managers toward data and UHC service indicators in a sub-district in Ugu, KwaZulu-Natal, South Africa. Operational managers saw data collection as information gathering, measuring performance and driving action. They understood UHC indicators as 'health for all' linking them to National Department of Health Strategic plans and saw the value of indicators for health promotion. They found the lack of training, inadequate numeracy skills, requests for data from multiple spheres of government and the indicator targets that they had to reach as challenging and untenable. While operational managers made the link between data, measuring performance and action, the limited training, skills gaps and pressures from higher levels of government may impede their ability to use data for local level planning and decision making. [ABSTRACT FROM AUTHOR]

Background: The emergence of drug resistance among pathogens has resulted in renewed interest in bioprospecting for natural microbial products. Methods: This study aimed to bioprospecting endophytic actinobacterium associated with Aloe ferox Mill for its antibacterial activity. Endophytic actinomycetes were isolated from the gel of A. ferox Mill by surface sterilization technique using actinomycete isolation agar. The isolate with a promising antibacterial activity was identified using 16S rRNA sequence analysis. The minimum inhibitory concentration (MIC) of the extract was assessed by the micro-dilution method and its effect on the respiratory chain dehydrogenase (RCD) activity was ascertained by the iodonitrotetrazolium chloride (INT) assay. Fourier transform-infrared spectrophotometer (FTIR) and gas chromatography-mass spectrophotometry (GC-MS) were employed to identify functional groups and the chemical constituents, respectively. Results: The actinobacterium was found to be Streptomyces olivaceus CP016795.1. Its extract displayed noteworthy antibacterial activity (MIC ≤1 mg/mL) against Staphylococcus aureus (ATCC 25925), Bacillus cereus (ATCC 10102), and Escherichia coli (ATCC 25922); and showed an inhibitory effect on the RCD activity. FTIR spectrum displayed hydroxyl, amine, and aromatic groups, and the GC–MS revealed 5-Hydroxymethylfurfural as the main constituent (19.47%). Conclusions: S. olivaceus CP016795.1 can serve as a potential source of effective antibacterial compounds. [ABSTRACT FROM AUTHOR]

The aim of this study is to predict the COVID-19 infection fifth wave in South Africa using the Gaussian mixture model for the available data of the early four waves for March 18, 2020-April 13, 2022. The quantification data is considered, and the time unit is used in days. We give the modeling of COVID-19 in South Africa and predict the future fifth wave in the country. Initially, we use the Gaussian mixture model to characterize the coronavirus infection to fit the early reported cases of four waves and then to predict the future wave. Actual data and the statistical analysis using the Gaussian mixture model are performed which give close agreement with each other, and one can able to predict the future wave. After that, we fit and predict the fifth wave in the country and it is predicted to be started in the last week of May 2022 and end in the last week of September 2022. It is predicted that the peak may occur on the third week of July 2022 with a high number of 19383 cases. The prediction of the fifth wave can be useful for the health authorities in order to prepare themselves for medical setup and other necessary measures. Further, we use the result obtained from the Gaussian mixture model in the new model formulated in terms of differential equations. The differential equations model is simulated for various values of the model parameters in order to determine the disease's possible eliminations. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to develop and validate, by consensus, the construct and content of an observations chart for nurses incorporating a modified early warning scoring (MEWS) system for physiological parameters to be used for bedside monitoring on general wards in a public hospital in South Africa. Methods: Delphi and modified face-to-face nominal group consensus methods were used to develop and validate a prototype observations chart that incorporated an existing UK MEWS. This informed the development of the Cape Town ward MEWS chart. Participants: One specialist anaesthesiologist, one emergency medicine specialist, two critical care nurses and eight senior ward nurses with expertise in bedside monitoring (N = 12) were purposively sampled for consensus development of the MEWS. One general surgeon declined and one neurosurgeon replaced the emergency medicine specialist in the final round. Results: Five consensus rounds achieved ≥70% agreement for cut points in five of seven physiological parameters respiratory and heart rates, systolic BP, temperature and urine output. For conscious level and oxygen saturation a relaxed rule of <70% agreement was applied. A reporting algorithm was established and incorporated in the MEWS chart representing decision rules determining the degree of urgency. Parameters and cut points differed from those in MEWS used in developed countries. Conclusions: A MEWS for developing countries should record at least seven parameters. Experts from developing countries are best placed to stipulate cut points in physiological parameters. Further research is needed to explore the ability of the MEWS chart to identify physiological and clinical deterioration. [ABSTRACT FROM AUTHOR]

Estimation equations based on different body segments are commonly used to predict height in patients whose height cannot be directly measured. This study aimed to assess the agreement between measured (reference) height and height predicted from published equations derived from measurement of body segments, in a South African public hospital setting. A descriptive cross-sectional study was undertaken. Medical, surgical, pulmonary, orthopaedic, cardiovascular and general wards at three public hospitals in Bloemfontein. Admitted patients, 20–50 years old; able to stand upright without assistance and without medical conditions or treatments affecting height. Stadiometer height, recumbent height, arm span, demi-span, ulna length, knee height, tibia length, fibula length and foot length were measured with standardised techniques. Height, predicted by 12 published equations, was compared with stadiometer height by 95% confidence intervals (CI) and Bland–Altman analysis. The median stadiometer height of the sample (n = 141; 38.3% female; median age 38.8 years, IQR 33.3–44.4 years) was 165.5 cm (males 169.3 cm; females 158.4 cm). Only a set of equations based on knee height and standardised on a large population of adults < 65 years in the United States estimated height without statistically significant deviance from the stadiometer height. Most standardised equations applied to hospitalised adults in a South African public health setting resulted in height estimations that differed significantly from height. Thus, equations standardised on other populations may not be suitable for the South African population, possibly due to differences in genetic and environmental factors. [ABSTRACT FROM AUTHOR]

Since 1999, many South African education policy documents have mandated integration of HIV & AIDS education in learning areas/disciplines. Policy document research has shown that although South African politicians and managers have produced volumes of eloquent and compelling legislation regarding provision for HIV & AIDS education, little of this is translated into action. The impact of HIV & AIDS permeates the social, economic and political arenas in South Africa. Integration of HI V & AIDS education across disciplines can serve as a strategy to further the ideals of social justice. This paper focuses on how integration in the teaching and learning of Mathematics Education provides opportunities to take action for social justice. The inquiry explores the following question: How can the myth that there is nothing we can do 'about HIV & AIDS, which is linked to social justice issues, be addressed through integration of HIV & AIDS education in Mathematics pre-service teacher education? Drawing on self-study, the work of a Mathematics teacher educator who worked with pre-service teachers to integrate HIV& AIDS education at a higher education institution is described. By considering integration of HIV & AIDS education in Mathematics Education and taking action it is possible to develop strategies which directly relate to social justice. [ABSTRACT FROM AUTHOR]

The purpose of the study was to determine pre-service accounting teachers' perceptions of the confidence and motivation in doing mathematics in Bachelor of Education Accounting courses at a higher education institution, with the aim of informing higher education heutagogy as it relates to teaching and learning in accounting. This study included a convenience sample of 255 preservice accounting teachers from a higher education institution in South Africa and a purposive sample of 18 students was drawn. Data collection was done through questionnaires and an interview schedule. A sequential explanatory design and sampling were employed. Data were analysed using SPSS for quantitative data and the interviews were transcribed and analysed qualitatively. The mean scores are above average (positive) for the cohort, however, there were numerous students with low scores in the effectance motivation and confidence scales. A more positive attitude towards effectance motivation in doing mathematics came from Indian, English and suburban respondents (p<.050). These students were not discouraged by difficult mathematical problems and are thus motivated by the challenges of mathematics. The interviews showed that parents positively influenced these students to persevere when faced with challenging mathematics problems. The results show no significant differences in the confidence in doing mathematics subscale (p >.050) in relation to gender, age, race group, mother tongue, Grade 12 mathematics, accounting module or location of schools. This finding runs counter to interview responses where 10 of the participants did not believe that they had a lot of selfconfidence when it comes to mathematical accounting calculations and could not do advanced work without seeking help from others, compared with 6 participants who agreed that they had a lot of selfconfidence when it comes to mathematical accounting calculations and could do advanced work without seeking help from others. In third-year accounting, strong significant connections were found between motivation in doing mathematics, confidence in doing mathematics and achievement in Accounting 420. [ABSTRACT FROM AUTHOR]

This study investigated the reading demands of restricted-use items1 administered to South African Grade 9 learners as part of the Trends in International Mathematics and Science Study (TIMSS) 2015. The method proposed by Mullis, Martin and Foy (2013) was used to categorise items into low, medium and high readability groups. The Knowing domain contained mostly low readability items, the Applying domain was almost equally medium and high readability items, with the Reasoning domain containing mostly high readability items. Results show significant differences between the percentage correctly answered between the low and high categories and between the medium and high categories. However, the full impact of reading demand on performance cannot be fully analysed without cross-reference to English proficiency. Nevertheless, the higher the readability, the greater the chance for learners to answer incorrectly. A continued expected low performance for most South African learners is implied. [ABSTRACT FROM AUTHOR]

The poor academic achievement and negative attitude of learners towards Mathematics are not only influenced by teaching styles but the learning styles as well. In other words, the mismatches between teaching and learning styles have a way of raising its ugly head in affecting effective classroom interaction and hence leads to poor performance in Mathematics. Therefore, this study investigated the correlation between learning styles and Grade 6 Mathematics performance. The study adopted correlational research design of quantitative approach. The target population for this study are Grade 6 learners in Buffalo City education district. Stratified sampling was used to select 1225 Grade 6 learners. The finding shows that Grade 6 learners with visual learning style (= 13.242, SD = 5.565) had the best performance in Mathematics at Buffalo City, followed by learners with auditory learning style (= 12.996, SD = 3.883), and learners with Kinaesthetic learning style (= 11.525, SD =3.800). It is recommended that teachers should be trained to know the different type of learning style exhibit by their learners to use them to impact knowledge and disseminate information to them since learning style could be described as a set of factors, behaviours and attitudes that facilitate learning for an individual in a given situation. [ABSTRACT FROM AUTHOR]

In this article we explore female learners' perceptions of learning Grade 11 geometry. Many learners have difficulty in learning geometry in mathematics, thus, teachers and researchers are constantly searching for reasons why learners have challenges with learning geometry with the aim of developing suitable pedagogic strategies to alleviate these challenges. An improvement in female learner performance advances learners' pass rates in mathematics, which has the potential to improve the economic status of South Africa. Data was generated from 1 secondary school for girls in the KwaZulu-Natal province, South Africa. Qualitative data was generated through the use of learner journal entries and focus group interviews. All generated data was coded and analysed using the NVivo software program. Employing Piaget's constructivist theory as a lens to analyse the data generated, the article highlights that the participants (N = 30) held both positive and negative perceptions of learning Grade 11 geometry. Findings from this study suggest that if teachers wanted to improve female learners' performance in mathematics, then important steps needed to be taken to alleviate learners' negative perceptions of learning Grade 11 geometry. Some suggestions are provided. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization recommends "same-day" initiation of antiretroviral therapy (ART) for HIV patients who are eligible and ready. Identifying efficient, safe, and feasible procedures for determining same-day eligibility and readiness is now a priority. The Simplified Algorithm for Treatment Eligibility (SLATE) study evaluated a clinical algorithm that allows healthcare workers to determine eligibility for same-day treatment and to initiate ART at the patient's first clinic visit.Methods and Findings: SLATE was an individually randomized trial at three outpatient clinics in urban settlements in Johannesburg, South Africa and three hospital clinics in western Kenya. Adult, nonpregnant, HIV-positive, ambulatory patients presenting for any HIV care, including HIV testing, but not yet on ART were enrolled and randomized to the SLATE algorithm arm or standard care. The SLATE algorithm used four screening tools-a symptom self-report, medical history questionnaire, physical examination, and readiness assessment-to ascertain eligibility for same-day initiation or refer for further care. Follow-up was by record review, and analysis was conducted by country. We report primary outcomes of 1) ART initiation ≤28 days and 2) initiation ≤28 days and retention in care ≤8 months of enrollment. From March 7, 2017 to April 17, 2018, we enrolled 600 patients (median [IQR] age 34 [29-40] and CD4 count 286 [128-490]; 63% female) in South Africa and 477 patients in Kenya (median [IQR] age 35 [29-43] and CD4 count 283 [117-541]; 58% female). In the intervention arm, 78% of patients initiated ≤28 days in South Africa, compared to 68% in the standard arm (risk difference [RD] [95% confidence interval (CI)] 10% [3%-17%]); in Kenya, 94% of intervention-arm patients initiated ≤28 days compared to 89% in the standard arm (6% [0.5%-11%]). By 8 months in South Africa, 161/298 (54%) intervention-arm patients had initiated and were retained, compared to 146/302 (48%) in the standard arm (6% [(2% to 14%]). By 8 months in Kenya, the corresponding retention outcomes were identical in both arms (137/240 [57%] of intervention-arm patients and 136/237 [57%] of standard-arm patients). Limitations of the trial included limited geographic representativeness, exclusion of patients too ill to participate, missing viral load data, greater study fidelity to the algorithm than might be achieved in standard care, and secular changes in standard care over the course of the study.Conclusions: In South Africa, the SLATE algorithm increased uptake of ART within 28 days by 10% and showed a numerical increase (6%) in retention at 8 months. In Kenya, the algorithm increased uptake of ART within 28 days by 6% but found no difference in retention at 8 months. Eight-month retention was poor in both arms and both countries. These results suggest that a simple structured algorithm for same-day treatment initiation procedures is feasible and can increase and accelerate ART uptake but that early retention on treatment remains problematic.Trial Registration: Clinicaltrials.gov NCT02891135, registered September 1, 2016. First participant enrolled March 6, 2017 in South Africa and July 13, 2017 in Kenya. [ABSTRACT FROM AUTHOR]

Background: We describe CD4 count recovery among HIV positive individuals who initiated antiretroviral therapy (ART) with and without severe immune suppression using complete laboratory data from South Africa’s national HIV treatment programme between 2010 and 2014 and discuss implications for CD4 count monitoring. Methods: Retrospective analysis of routinely collected laboratory data from South Africa’s National Health Laboratory Service (NHLS). A probabilistic record linkage algorithm was used to create a cohort of HIV positive individuals who initiated ART between 2010 and 2014 based on timing of CD4 count and viral load measurements. A CD4 count < 50 copies/μl at ART initiation was considered severe immunosuppression. A multivariable piecewise mixed-effects linear regression model adjusting for age, gender, year of starting ART, viral suppression in follow up and province was used to predict CD4 counts during follow up. Results: 1,070,900 individuals had evidence of starting ART during 2010–2014 and met the criteria for inclusion in the cohort -46.6% starting ART with CD4 < 200 cells/μl and 10.1% with CD4 < 50 cells/ μl. For individuals with CD4 counts < 200 cells/μl, predicted CD4 counts > 200 cells/μl, >350 cells/μl and >500 cells/μl corresponded with mean follow up durations of 1.5 years (standard deviation [s.d] 1.1), 1.9years (s.d 1.2) and 2.1 years (s.d 1.3 years). For those with CD4 counts < 50 cells/μl, predicted CD4 count above these threshold corresponded with mean follow up durations of 2.5 years (s.d 0.9 years), 4.4 years (s.d 0.4 years) and 5.0 years (s.d 0.1years) for recovery to the same thresholds. CD4 count recovery varied mostly with duration on ART, CD4 count at the start of ART and gender. Conclusion: For individuals starting with ART with severe immunosuppression, CD4 recovery to 200cells/μl did not occur or took longer than 12 month for significant proportions. CD4 monitoring and interventions recommended for advanced HIV disease should continue until full recovery. [ABSTRACT FROM AUTHOR]

Background: Pre-university education curriculum changes may increase the skills and knowledge gap between secondary (high school) and tertiary (university) education that have been identified as having a major impact on the success of students from underresourced educational backgrounds. This study investigated the impact of extensive pre-university curriculum revision on the generic learning skills of entrants to South African medical schools, which admit students directly from high school. Methods: In this prospective study, students entering four medical schools during 2008–2011 were surveyed to determine their practice of and confidence in information handling, managing own learning, technical and numeracy skills, and computer, organizational, and presentation skills in the 12-month preceding entry. The 2008 entrants were the final cohort of the old secondary school curriculum. The mean levels of practice or confidence of entrants to the four medical schools, during 2008–2011, were compared using analysis of variance. The Bonferroni's test was used for further pair-wise comparison of cohorts of students either entering in different years or different institutions. Results: While entrants at the four medical schools did not demonstrate a consistent or sustained change in their practice of or confidence in each skill category over the period of study, there were some significant differences between entrants at the respective institutions. Furthermore, entrants to one medical school were consistently less confident of their skills, despite more practice. These findings are best accounted for by the long-standing history of inequitably resourced pre-university education in South Africa. Discussion: These findings highlight the need for close monitoring of the impact of pre-university education changes on the learning skill profiles of university entrants, in order to design effective university programs which enable students from diverse backgrounds to participate and adequately meet curricula demands. [ABSTRACT FROM AUTHOR]

Background: South Africa has undergone multiple expansions in antiretroviral therapy (ART) eligibility from an initial CD4+ threshold of ≤200 cells/μl to providing ART for all people living with HIV (PLWH) as of September 2016. We evaluated the association of programmatic changes in ART eligibility with loss from care, both prior to ART initiation and within the first 16 weeks of starting treatment, during a period of programmatic expansion to ART treatment at CD4+ ≤ 350 cells/μl.Methods and Findings: We performed a retrospective cohort study of 4,025 treatment-eligible, non-pregnant PLWH accessing care in a community health center in Gugulethu Township affiliated with the Desmond Tutu HIV Centre in Cape Town. The median age of participants was 34 years (IQR 28-41 years), almost 62% were female, and the median CD4+ count was 173 cells/μl (IQR 92-254 cells/μl). Participants were stratified into 2 cohorts: an early cohort, enrolled into care at the health center from 1 January 2009 to 31 August 2011, when guidelines mandated that ART initiation required CD4+ ≤ 200 cells/μl, pregnancy, advanced clinical symptoms (World Health Organization [WHO] stage 4), or comorbidity (active tuberculosis); and a later cohort, enrolled into care from 1 September 2011 to 31 December 2013, when the treatment threshold had been expanded to CD4+ ≤ 350 cells/μl. Demographic and clinical factors were compared before and after the policy change using chi-squared tests to identify potentially confounding covariates, and logistic regression models were used to estimate the risk of pre-treatment (pre-ART) loss from care and early loss within the first 16 weeks on treatment, adjusting for age, baseline CD4+, and WHO stage. Compared with participants in the later cohort, participants in the earlier cohort had significantly more advanced disease: median CD4+ 146 cells/μl versus 214 cells/μl (p < 0.001), 61.1% WHO stage 3/4 disease versus 42.8% (p < 0.001), and pre-ART mortality of 34.2% versus 16.7% (p < 0.001). In total, 385 ART-eligible PLWH (9.6%) failed to initiate ART, of whom 25.7% died before ever starting treatment. Of the 3,640 people who started treatment, 58 (1.6%) died within the first 16 weeks in care, and an additional 644 (17.7%) were lost from care within 16 weeks of starting ART. PLWH who did start treatment in the later cohort were significantly more likely to discontinue care in <16 weeks (19.8% versus 15.8%, p = 0.002). After controlling for baseline CD4+, WHO stage, and age, this effect remained significant (adjusted odds ratio [aOR] = 1.30, 95% CI 1.09-1.55). As such, it remains unclear if early attrition from care was due to a "healthy cohort" effect or to overcrowding as programs expanded to accommodate the broader guidelines for treatment. Our findings were limited by a lack of generalizability (given that these data were from a single high-volume site where testing and treatment were available) and an inability to formally investigate the effect of crowding on the main outcome.Conclusions: Over one-quarter of this ART-eligible cohort did not achieve the long-term benefits of treatment due to early mortality, ART non-initiation, or early ART discontinuation. Those who started treatment in the later cohort appeared to be more likely to discontinue care early, and this outcome appeared to be independent of CD4+ count or WHO stage. Future interventions should focus on those most at risk for early loss from care as programs continue to expand in South Africa. [ABSTRACT FROM AUTHOR]

Many learners with different learning challenges are accommodated in the same classroom in South Africa, which could result in poor performance in mathematics. By reinforcing or disregarding certain goals, a teacher can influence the way in which learners learn mathematics. This study compared the achievement goal orientation of Grade Nine mathematics learners in a conventional classroom. The two groups studied were learners experiencing attention-deficit hyperactivity disorder (ADHD) and learners without ADHD. A quantitative, exploratory research design was used. Twenty Grade Nine learners, of whom 10 experienced ADHD, were purposefully selected from one school in Ekurhuleni-East, South Africa. Data was collected with an existing questionnaire. The results revealed that while learners without ADHD compare themselves against their peers' behavioural and cognitive engagement, as well as the level of their mastery goal orientation, learners with ADHD rely more on their personal performance-avoidance goal orientation and the goal orientation of their parents. Differences between the achievement goal orientation of mathematics learners with or without ADHD could assist teachers in recognising methods to direct learners' goals for better engagement with and improved results in mathematics, which could support learners to develop to their full potential in the subject. [ABSTRACT FROM AUTHOR]

Rapid diagnostic tools have been shown to improve linkage of patients to care. In the context of infectious diseases, assessing the impact and cost-effectiveness of such tools at the population level, accounting for both direct and indirect effects, is key to informing adoption of these tools. Point-of-care (POC) CD4 testing has been shown to be highly effective in increasing the proportion of HIV positive patients who initiate ART. We assess the impact and cost-effectiveness of introducing POC CD4 testing at the population level in South Africa in a range of care contexts, using a dynamic compartmental model of HIV transmission, calibrated to the South African HIV epidemic. We performed a meta-analysis to quantify the differences between POC and laboratory CD4 testing on the proportion linking to care following CD4 testing. Cumulative infections averted and incremental cost-effectiveness ratios (ICERs) were estimated over one and three years. We estimated that POC CD4 testing introduced in the current South African care context can prevent 1.7% (95% CI: 0.4% - 4.3%) of new HIV infections over 1 year. In that context, POC CD4 testing was cost-effective 99.8% of the time after 1 year with a median estimated ICER of US$4,468/DALY averted. In healthcare contexts with expanded HIV testing and improved retention in care, POC CD4 testing only became cost-effective after 3 years. The results were similar when, in addition, ART was offered irrespective of CD4 count, and CD4 testing was used for clinical assessment. Our findings suggest that even if ART is expanded to all HIV positive individuals and HIV testing efforts are increased in the near future, POC CD4 testing is a cost-effective tool, even within a short time horizon. Our study also illustrates the importance of evaluating the potential impact of such diagnostic technologies at the population level, so that indirect benefits and costs can be incorporated into estimations of cost-effectiveness. [ABSTRACT FROM AUTHOR]

Copyright of Dirasat: Educational Sciences is the property of University of Jordan and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: HIV-exposed uninfected (HEU) infants are a growing population in sub-Saharan Africa especially with the increasing coverage of more effective prevention of mother-to-child transmission (PMTCT) antiretroviral therapy regimens. This study describes the characteristics of South African HEU infants, investigates factors impacting birth weight and assesses their growth within the first 28 weeks of life. Methods: This is a retrospective cohort based on routine clinical data from two South African PMTCT programmes. Data were collected between 2007 and 2013. Linear regression assessed factors affecting birth weight-for-age z-scores (WAZ) while growth (longitudinal WAZ) was assessed using mixed effects models. Results: We assessed the growth of 2621 HEU infants (median birth WAZ was -0.65 (IQR -1.46; 0.0) and 51% were male). The feeding modalities practised were as follows: 0.5% exclusive breastfeeding, 7.9% breastfeeding with unknown exclusivity, 0.08% mixed breastfeeding and 89.2% formula feeding. Mothers with CD4 <200 cells/μl delivered infants with a lower birth WAZ (adjusted ß -0.253 [95% CI -0.043; -0.072], p = 0.006) compared to mothers with aCD4 ≥500 cells/μl. Similarly, mothers who did not receive antiretroviral drugs delivered infants with a lower birth WAZ (adjusted ß -0.39 [95% CI -0.67; -0.11], p = 0.007) compared to mothers who received antenatal antiretrovirals. Infants with a birth weight <2 500g (ß 0.070 [95% CI 0.061; 0.078], p <0.0001) experienced faster growth within the first 28 weeks of life compared to infants with a birth weight ≥2 500g. Infants with any breastfeeding exposure experienced slower longitudinal growth compared to formula fed infants (adjusted ß -0.012 [95% CI 0.021; -0.003], p = 0.011). Conclusion: Less severe maternal disease and the use of antiretrovirals positively impacts birth weight in this cohort of South African HEU infants. Formula feeding was common with breastfed infants experiencing marginally slower longitudinal growth. [ABSTRACT FROM AUTHOR]

Understanding HIV transmission dynamics is critical to estimating the potential population-wide impact of HIV prevention and treatment interventions. We developed an individual-based simulation model of the heterosexual HIV epidemic in South Africa and linked it to the previously published Cost-Effectiveness of Preventing AIDS Complications (CEPAC) International Model, which simulates the natural history and treatment of HIV. In this new model, the CEPAC Dynamic Model (CDM), the probability of HIV transmission per sexual encounter between short-term, long-term and commercial sex worker partners depends upon the HIV RNA and disease stage of the infected partner, condom use, and the circumcision status of the uninfected male partner. We included behavioral, demographic and biological values in the CDM and calibrated to HIV prevalence in South Africa pre-antiretroviral therapy. Using a multi-step fitting procedure based on Bayesian melding methodology, we performed 264,225 simulations of the HIV epidemic in South Africa and identified 3,750 parameter sets that created an epidemic and had behavioral characteristics representative of a South African population pre-ART. Of these parameter sets, 564 contributed 90% of the likelihood weight to the fit, and closely reproduced the UNAIDS HIV prevalence curve in South Africa from 1990–2002. The calibration was sensitive to changes in the rate of formation of short-duration partnerships and to the partnership acquisition rate among high-risk individuals, both of which impacted concurrency. Runs that closely fit to historical HIV prevalence reflect diverse ranges for individual parameter values and predict a wide range of possible steady-state prevalence in the absence of interventions, illustrating the value of the calibration procedure and utility of the model for evaluating interventions. This model, which includes detailed behavioral patterns and HIV natural history, closely fits HIV prevalence estimates. [ABSTRACT FROM AUTHOR]

In this article the author discusses the use of temporal dimensions in South Africa's primary school mathematics teachings to improve poor understanding. It discusses two interconnected temporal dimensions which include mathematical temporality related to mathematical ideas and their precursors, and mathematical learning temporality providing the ground for future learning. It mentions that South Africa's national mean percentage mark was 41 percent in grade three numeracy tests in 2012.

Objectives: Mortality in patients starting antiretroviral therapy (ART) is higher in Malawi and Zambia than in South Africa. We examined whether different monitoring of ART (viral load [VL] in South Africa and CD4 count in Malawi and Zambia) could explain this mortality difference. Design:: Mathematical modelling study based on data from ART programmes. Methods: We used a stochastic simulation model to study the effect of VL monitoring on mortality over 5 years. In baseline scenario A all parameters were identical between strategies except for more timely and complete detection of treatment failure with VL monitoring. Additional scenarios introduced delays in switching to second-line ART (scenario B) or higher virologic failure rates (due to worse adherence) when monitoring was based on CD4 counts only (scenario C). Results are presented as relative risks (RR) with 95% prediction intervals and percent of observed mortality difference explained. Results: RRs comparing VL with CD4 cell count monitoring were 0.94 (0.74–1.03) in scenario A, 0.94 (0.77–1.02) with delayed switching (scenario B) and 0.80 (0.44–1.07) when assuming a 3-times higher rate of failure (scenario C). The observed mortality at 3 years was 10.9% in Malawi and Zambia and 8.6% in South Africa (absolute difference 2.3%). The percentage of the mortality difference explained by VL monitoring ranged from 4% (scenario A) to 32% (scenarios B and C combined, assuming a 3-times higher failure rate). Eleven percent was explained by non-HIV related mortality. Conclusions: VL monitoring reduces mortality moderately when assuming improved adherence and decreased failure rates. [ABSTRACT FROM AUTHOR]

Introduction: Providing private antiretroviral therapy (ART) care for public sector patients could increase access to ART in low- and middle-income countries. We compared the costs and outcomes of a private-care and a public-care ART program in South Africa. Methods: A novel Markov model was developed from the public-care program. Patients were first tunneled for 6 months in their baseline CD4 category before being distributed into a dynamic CD4 and viral load model. Patients were allowed to return to ART care from loss to follow up (LTFU). We then populated this modeling framework with estimates derived from the private-care program to externally validate the model. Results: Baseline characteristics were similar in the two programs. Clinic visit utilization was higher and death rates were lower in the first few years on ART in the public-care program. After 10 years on ART we estimated the following outcomes in the public-care and private-care programs respectively: viral load <1000 copies/ml 89% and 84%, CD4 >500 cells/μl 33% and 37%, LTFU 14% and 14%, and death 27% and 32%. Lifetime undiscounted survival estimates were 14.1 (95%CI 13.2–14.9) and (95%CI 12.7–14.5) years with costs of 18,734 (95%CI 12,588–14,022) and 13,062 (95%CI 12,077–14,047) USD in the private-care and public-care programs respectively. When clinic visit utilization in the public-care program was reduced by two thirds after the initial 6 months on ART, which is similar to their current practice, the costs were comparable between the programs. Conclusions: Using a novel Markov model, we determined that the private-care program had similar outcomes but lower costs than the public-care program, largely due to lower visit frequencies. These findings have important implications for increasing and sustaining coverage of patients in need of ART care in resource-limited settings. [ABSTRACT FROM AUTHOR]

Groundwater discharge is believed to dominate dry season flows in perennial river systems and to sustain aquatic biodiversity. River flow Statistics, extracted from the SPATSIM modelling system, were used to estimate the contribution of groundwater to river flow regimes. The flow statistics were compared for the principal aquifer types (based on major geological formations) in South Africa. This analysis focused on seasonal variation in flows rather than the annual totals or Baseflow Index. Groundwater discharge is expected to reduce flow variability and sustain flows, making flow concentrations lower than rainfall concentrations. Catchments dominated by carbonates have the greatest proportion of baseflow (37%), followed by basement complex (31%) and extrusive aquifer types (31%). The weak relationships between river flow indexes (particularly the Baseflow Index, Coefficient of Variation and Hydrological Index) and the seasonality or concentration statistics imply that catchment storage characteristics and other non-climatic factors play an important role in flow regulation. The geographic distribution of total flow concentrations differs markedly from rainfall concentrations, further evidence that non-climatic factors are important determinants of flow regimes. Karoo dykes and sills, extrusives and unconsolidated deposits are under-represented and the TMG sub-type, carbonates and basement complex and younger granites are over-represented among catchments with evenly distributed baseflows. The Baseflow Index and groundwater-fed baseflow are ecologically meaningful variables but lack clear thresholds that correspond with ecologically important changes in river flow regimes, for example perennial versus seasonal flow. Flow concentrations and percentage zero flows are useful and potentially ecologically important variables and should be tested as predictors of the aquatic and riparian biodiversity of river systems at a range of scales. [ABSTRACT FROM AUTHOR]

The article presents the results of the study on the estimated returns to education in South Africa. The study uses the familiar within-family method, as well as variants of the family-effects models, to minimize omitted variables bias in a South African data set from 1993. Thirteen percent of respondents were resurveyed to achieve estimates of the reliability of measured schooling. The results suggest that the within-family fixed-effects estimates should be biased downwards to a considerable extent. The author also shows that errors in the schooling variable are strongly correlated within the family, and that this decreases the degree of attenuation bias in the fixed-effects model. The schooling coefficients for Africans that are less than half as large as the ordinary least-squares results were achieved after correcting for the correlated, nonclassical measurement errors.