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The power of app-driven mobile phones was first unleashed in 2011 when they were used to mobilize protesters and gain support for political movements in the United States and abroad. Mobile devices have since become the bedrock of political activism. To examine the influence of app reliance on offline and online political participation, this study builds on the Orientation-Stimulus-Reasoning-Orientation-Response (O-S-R-O-R) model by (a) applying the model to mobile apps, (b) testing whether trust in, and reliance on political discussion are mediators between reliance on apps and political participation, and (c) using trust in both offline and online discussion as measures of cognitive elaboration. This study’s path model suggests that app reliance is related to online political discussion, which, in turn, is related to online political participation, but not offline participation. Although both offline and online discussion are linked to offline and online trust in political discussion, trust in political discussion does not influence either offline or online political participation.

With respect to supporting student well-being and success, the current research developed a peer support scheme, built on the principles of Social Identity Theory (SIT). This was targeted towards f...

Background There is a growing number of adolescents and young adults living with HIV (YPLHIV) who require the transfer of care from pediatric/ adolescent clinics to adult Antiretroviral therapy (ART) clinics. A successful transition is critical for optimum health outcomes, yet facilities may lack infrastructure, human resources (with appropriate knowledge and skills), and a supportive environment, as only 3% of clinics in Uganda caring for YPLHIV have a process for supporting this critical transition from pediatric to adult care, and, facilitators and barriers of a successful transition are not well documented. The purpose of this study was to explore the facilitators and barriers of transitioning among adolescents from adolescent clinics to adult ART clinics. Method Eighteen focus group discussions were held in nine health facilities with 174 adolescents and YPLHIV to assess barriers and facilitators regarding transitioning to adult clinics. The focus group discussions were audio-recorded and transcribed. The Silences Framework using a thematic approach guided the analysis. Results The key emerging issues were: Unfriendly adults in adult clinics, Care provided in the adolescent clinics, fear of stigma from health care providers, Congestion and long waiting time, fear to lose friends were barriers to transitioning. Transitioning preparation is key to a successful transition, moving as a cohort facilitates transition, and care in adult clinics offers new opportunities, could facilitate readiness and transition. Conclusion YPLHIV expressed fear to transition to adult clinics mainly because of the perceived better care provided in the adolescent clinic, thus constituting a barrier to smooth transition A range of individual, social and health system and services-related factors hindered transitioning. The expectation of transitioning as a group, assurance of similar care as in the adolescent clinic, and guarantees of confidentiality, privacy, and autonomy in decision-making for care was perceived as facilitators. Understanding barriers and facilitators can enable the Ministry of Health to improve the quality of life of YPLHIV through linkage to care, adherence, retention, and viral suppression. There is a need to better planning and preparation for clinical providers and YPLHIV with a focus on age-appropriate and individualized case management transition as well as focus on improving both clinical and psychosocial support throughout the process.

Background Early discontinuation of implant contraceptive methods and reasons for discontinuation remains a major concern for family planning programs. Early discontinuation is related to higher rates of the overall fertility rate, unwanted pregnancies leading to possibly induced abortion. There is paucity of data on the practice of discontinuation of contraceptives in developing countries. The objective of the study was to determine the magnitude of early implants discontinuation among women receiving implants services in the study area and the factors associated with it. Methods A cross-sectional study was conducted from 2nd January to 3rd March 2020. Data were collected from 207 women who had come to remove implants on socio-demographic characteristics, obstetric history, duration of implant, and reasons for wanting to remove the implant. We computed the proportion of those who removed the implant before 18 months (early discontinuation). To assess the factors associated with early discontinuation, we estimated the prevalence ratios with a generalized linear model of the poisson family with a log link and robust error variance. Results The proportion of early implant discontinuation was 87/207(42%). Factor associated with early implant discontinuation included; experience of side effects (PR = 1.1; 95% CI 1.03–1.24; P = 0.001), not having received pre-insertion counseling about the benefits and side effects of contraceptive implants (PR = 1.5; 95% CI 1.02–1.30; P = 0.019) and staying in rural areas (PR = 1.1; 95% CI 1.03–1.27; P = 0.014). Conclusion Nearly one in every two mothers have early discontinuation of contraceptive implants. Factors associated with early implant removal include; experience of side effects, lack of counseling services, and staying in rural areas. There is a need for intervention to address high prevalence of early contraceptive removal through improving on counselling services about possible side effects.

Almost all news media, political organizations and candidates now have a dedicated app that provides superior visibility and readability on a mobile device than a website. Mobile apps figure predom...

Background/Aims The majority of maternal deaths occur during labour, delivery, or within the first 4 hours after birth. This can be reduced by the care that midwives provide. At Mulago Hospital, little is documented on midwives' current practice and their perception of care offered during labor and delivery. The number of maternal and neonatal deaths as a result of preventable causes such as postpartum haemorrhage, obstructed labour, ruptured uterus and sepsis remains high. The aim of this study was to document the current practice of midwives, explore midwives' perception towards practice and identify factors that influence practice during birth in Uganda, to identify possible areas for improvement. Methods A cross-sectional study was conducted of midwives working in the three labour wards at the Mulago National referral hospital: the general ward, the private ward and the midwifery-led ward. Midwives' perceptions were explored using a semi-structured questionnaire, which asked midwives about their current practice and their perception of the care offered. Findings Care was found to be lacking in several areas. Only one-fifth (20.0%) of midwives reported always checking temperature every 4 hours. Only 20.5% reported that women are always supported in being mobile during labour. Less than half of the midwives (44.4%) knew the recommended drugs for managing the third stage of labour. Infection prevention practices were poor. Only 54% of midwives knew how to prepare magnesium sulphate for management of severe pre-eclampsia and eclampsia. Overall, the general labour ward was found to have the most gaps in midwives' knowledge. Lack of continuing education, supplies, teamwork and clinical guidelines were reported to affect practice. Staff shortages and midwives' decisions being underlooked by obstetricians were also reported to affect practice. Conclusions Overall, the study found that midwifery practice is suboptimal in key areas such as infection prevention, use of a partograph, and management of pre-eclampsia and eclampsia. Continuous professional development, provision of resources, and strengthening teamwork are recommended to improve maternal health outcomes at Mulago Hospital.

Background Pelvic organ prolapse (POP) is a significant public health issue that negatively affects the Quality of Life (QOL) of women in both low and high-income countries. About 20% of women will undergo surgery for POP over their lifetime. However, there is a paucity of information on the effect of surgery on QOL especially in resource-limited settings. We therefore assessed the QOL among women with symptomatic POP living in rural southwestern Uganda and the impact of surgery on their quality of life. Methods We conducted a prospective cohort study among 120 women with symptomatic POP scheduled for surgery at the urogynecology unit of Mbarara Regional Referral Hospital. The QOL at baseline and at 1 year after surgery in the domains of physical performance, social interaction, emotional state, sexual life, sleep quality, personal hygiene and urinary bladder function was determined using a King’s Quality of Life questionnaire. A paired t-test was used to compare the difference in mean scores at baseline and at 1-year post-surgery. Results Of the 120 participants that were enrolled at baseline, 117(98%) completed the follow-up period of 1 year. The baseline QOL was poor. The domains with the poorest QOL were physical, social, sexual, emotional and sleep quality. The mean QOL scores in all the domains and the overall QOL significantly improved 1 year after surgery (p Conclusions The QOL was poor among women with symptomatic POP and surgery improved the QOL in all the domains of life. We recommend that surgery as an option for treatment of symptomatic POP should be scaled up to improve on the QOL of these women.

Introduction and hypothesis This study was aimed at determining the recurrence rate and risk factors for the recurrence of pelvic organ prolapse (POP), at 1 year post-vaginal reconstructive surgery in a resource-limited setting. Methods We enrolled women who underwent vaginal surgery for POP at the urogynecology unit of Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda between December 2018 and February 2020. The surgeries that were performed include anterior colporrhaphy for cystocele, posterior colporrhaphy for rectocele, vaginal hysterectomy with vault suspension for uterine prolapse, and cervicopexy in those with uterine prolapse where uterine-sparing surgery was desired. The women were followed up for a period of 1 year after surgery. Pelvic examinations in lithotomy position under maximum strain were carried out to assess for recurrence using the Pelvic Organ Quantification (POP-Q) system. Recurrence was defined as a prolapse of ≥POP-Q stage II. Descriptive analyses and multivariate log binomial regression were performed to determine risk factors for recurrence. Results Of the 140 participants enrolled, 127 (90.7%) completed the follow-up at 1 year. The recurrence rate was 25.2% (32 out of 127). Most (56.3%) of the recurrences occurred in the anterior compartment and in the same site previously operated. Women aged p = 0.018) and those who had postoperative vaginal cuff infection (RR = 2.54; 95% CI: 1.5–4.3; p = 0.001) were at risk of recurrence. Conclusion Recurrence of POP was common. Younger women, and those with postoperative vaginal cuff infection, were more likely to experience recurrent prolapse after vaginal repair.

Background Transition readiness refers to a client who knows about his/her illness and oriented towards future goals and hopes, shows skills needed to negotiate healthcare, and can assume responsibility for his/ her treatment, and participate in decision-making that ensures uninterrupted care during and after the care transition to adult HIV care. There is a paucity of research on effective transition strategies. This study explored factors associated with adolescent readiness for the transition into adult care in Uganda. Methods A cross-sectional study was conducted among 786 adolescents, and young people living with HIV randomly selected from 9 antiretroviral therapy clinics, utilizing a structured questionnaire. The readiness level was determined using a pre-existing scale from the Ministry of Health, and adolescents were categorized as ready or not ready for the transition. Bivariate and multivariate analyses were conducted. Results A total of 786 adolescents were included in this study. The mean age of participants was 17.48 years (SD = 4). The majority of the participants, 484 (61.6%), were females. Most of the participants, 363 (46.2%), had no education. The majority of the participants, 549 (69.8%), were on first-line treatment. Multivariate logistic regression analysis found that readiness to transition into adult care remained significantly associated with having acquired a tertiary education (AOR 4.535, 95% CI 1.243–16.546, P = 0.022), trusting peer educators for HIV treatment (AOR 16.222, 95% CI 1.835–143.412, P = 0.012), having received counselling on transition to adult services (AOR 2.349, 95% CI 1.004–5.495, P = 0.049), having visited an adult clinic to prepare for transition (AOR 6.616, 95% CI 2.435–17.987, P = < 0.001) and being satisfied with the transition process in general (AOR 0.213, 95% CI 0.069–0.658, P = 0.007). Conclusion The perceived readiness to transition care among young adults was low. A series of individual, social and health system and services factors may determine successful transition readiness among adolescents in Uganda. Transition readiness may be enhanced by strengthening the implementation of age-appropriate and individualized case management transition at all sites while creating supportive family, peer, and healthcare environments.

Background Whereas many adolescents and young people with HIV require the transfer of care from paediatric/adolescent clinics to adult ART clinics, this transition is beset with a multitude of factors that have the potential to hinder or facilitate the process, thereby raising ethical challenges of the transition process. Decisions made regarding therapy, such as when and how to transition to adult HIV care, should consider ethical benefits and risks. Understanding and addressing ethical challenges in the healthcare transition could ensure a smooth and successful transition. The purpose of this study was to analyze the ethical challenges of transitioning HIV care for adolescents into adult HIV clinics. Methods Data presented were derived from 191 adolescents attending nine different health facilities in Uganda, who constituted 18 focus group discussions. In the discussions, facilitators and barriers regarding adolescents transitioning to adult HIV clinics were explored. Guided by the Silences Framework for data interpretation, thematic data analysis was used to analyze the data. The principles of bioethics and the four-boxes ethics framework for clinical care (patient autonomy, medical indications, the context of care, and quality of life) were used to analyze the ethical issues surrounding the transition from adolescent to adult HIV care. Results The key emerging ethical issues were: reduced patient autonomy; increased risk of harm from stigma and loss of privacy and confidentiality; unfriendly adult clinics induce disengagement and disruption of the care continuum; patient preference to transition as a cohort, and contextual factors are critical to a successful transition. Conclusion The priority outcomes of the healthcare transition for adolescents should address ethical challenges of the healthcare transition such as loss of autonomy, stigma, loss of privacy, and discontinuity of care to ensure retention in HIV care, facilitate long-term self-care, offer ongoing all-inclusive healthcare, promote adolescent health and wellbeing and foster trust in the healthcare system. Identifying and addressing the ethical issues related to what hinders or facilitates successful transitions with targeted interventions for the transition process may ensure adolescents and young people with HIV infection remain healthy across the healthcare transition.

Research has examined how standardized tests give rise to gender differences in English and STEM attainment, but little research has explored gender differences in classroom-based attainment and the degree to which these correspond to differences in school-related attitudes. To explore the extent to which gender-achievement gaps in classroom-based performance parallel differences in self-perceptions and scholastic attitudes. An independent sample of first (n = 187, age 11–12, Study 1) and second-year students (n = 113, age 12–13, Study 2) from a UK comprehensive secondary school completed a questionnaire measuring academic mindset, self-efficacy, self-concept, competence beliefs, personal and social self-esteem, and endorsement of gender-subject and career stereotypes. Responses were then matched to their respective classroom grades in English, mathematics, science, and computing. Girls outperformed boys in English in their first year but reported lower global self-esteem and greater endorsement of science-career stereotypes. Conversely, girls outperformed boys in mathematics in their second year, but paradoxically reported lower self-concept and competence beliefs in mathematics and science, and higher competence beliefs in English. Across both studies, mindset, self-efficacy, competence beliefs, and social self-esteem were positively related to English attainment; academic self-efficacy was positively related to mathematics attainment; and mindset, self-efficacy, self-concept, and competence beliefs were positively related to science attainment. Gender-achievement gaps in classroom-based academic attainment are complex and highly nuanced; they appear to vary between school subjects across years and may not correspond with similar differences in self-perceptions and scholastic attitudes.

This chapter provides an overview of the current conceptual and methodological challenges in light of gaming disorder recently being included in the ICD-11 (WHO, Gaming disorder, 2018). This is discussed in reference to the DSM-5 (APA, Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association, 2013) with its more tentative approach of adding Internet gaming disorder (IGD) in the appendix as a condition for further study. The debate is summarised to present the disparities between these two diagnostic manuals, along with a range of other key conceptual challenges which call for a cautious approach when inferring diagnostic efficacy from these clinical manuals. These issues include definitional differences, impact of game classifications and the various behaviours afforded to these based on game type, game function and form of gaming. Further to this, methodological issues are drawn out to highlight the potential limitations of the academic evidence base in this field. As such, this chapter provides a critical review of the conceptual issues with considerations of the practical and clinical implications.

Appendix: Final 40 Research Priorities included in survey of psychological scientists is available at https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/bjop.12468#bjop12468-app-0001-title . Copyright © 2020 The Authors. The severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) that has caused the coronavirus disease 2019 (COVID‐19) pandemic represents the greatest international biopsychosocial emergency the world has faced for a century, and psychological science has an integral role to offer in helping societies recover. The aim of this paper is to set out the shorter‐ and longer‐term priorities for research in psychological science that will (a) frame the breadth and scope of potential contributions from across the discipline; (b) enable researchers to focus their resources on gaps in knowledge; and (c) help funders and policymakers make informed decisions about future research priorities in order to best meet the needs of societies as they emerge from the acute phase of the pandemic. The research priorities were informed by an expert panel convened by the British Psychological Society that reflects the breadth of the discipline; a wider advisory panel with international input; and a survey of 539 psychological scientists conducted early in May 2020. The most pressing need is to research the negative biopsychosocial impacts of the COVID‐19 pandemic to facilitate immediate and longer‐term recovery, not only in relation to mental health, but also in relation to behaviour change and adherence, work, education, children and families, physical health and the brain, and social cohesion and connectedness. We call on psychological scientists to work collaboratively with other scientists and stakeholders, establish consortia, and develop innovative research methods while maintaining high‐quality, open, and rigorous research standards. Christopher Armitage's contribution is supported by the NIHR Manchester Biomedical Research Centre and the NIHR Greater Manchester Patient Safety Translational Research Centre. Til Wykes would like to acknowledge the support of her NIHR Senior Investigator Award.

Background Rwanda has a high unmet need for family planning which could be reduced by improving access to postpartum intrauterine contraceptives device (PPIUCD) insertion. The objective of the study was to assess the prevalence and factors associated with the uptake of PPIUCD among postpartum women in Muhima Hospital. Methods A concurrent mixed-method study was used. Three hundred eight three (383) immediate postpartum mothers, and 10 health services providers were interviewed using a structured questionnaire and in-depth interviews respectively. Logistics regression was done to assess for factors associated with PPIUCD uptake and thematic analysis was used for qualitative data. Results The prevalence for PPIUCD use was 28.1%, women who had spontaneous vaginal delivery were more likely to take up PPIUCD (Adjusted Odds Ratio (AOR) 2.623, 95% CI = 2.017–6.507 compared to those who had cesarean section; women who received PPIUCD counselling during the antenatal period were more likely to use PPIUCD ((AOR 2.072, 95% CI = 1.018–4.218) as compared to those who didn’t receive any form of counselling; mothers who received spouse approval were more likely to use PPIUCD (AOR 2.591,95% CI = 1.485–4.492); as compared to those who didn’t receive any spousal approval; women who had more than one child were more likely to use PPIUCD (AOR =2.265, 95% CI = 1.472–3.163) as compared to prime gravida; Mothers with birth to pregnancy interval less than two years were more likely to use PPIUCD (AOR =2.123, CI =1.477–2.706) as compared to those who had birth to pregnancy interval more than 2 years. From the qualitative findings, health education of mothers and partners on PPIUCD, training of health care providers, and availability of supplies to provide PPIUCD influenced the use of PPIUCD. Conclusion The acceptability to use for PPIUCD was high in this population. PPIUCD uptake was associated with normal birth, PPIUCD counselling, spousal approval, parity, birth interval, level of education. Health education of mothers and partners on PPIUCD, training of health providers, and availability of supplies to provide PPIUCD influenced uptake of PPIUCD.

Background Randomized controlled trials (RCTs) are central to generating knowledge about effectiveness of interventions as well as risk, protective and prognostic factors related to diseases in emergency newborn care. Whether prospective participants understand the purpose of research, and what they perceive as the influence of the context on their understanding of the informed consent process for RCTs in emergency obstetric and newborn care are not well documented. Methods Conceptual review. Discussion Research is necessary to identify how the illnesses may be prevented, to explore the causes, and to investigate what medications could be used to manage such illness. Voluntary informed consent requires that prospective participants understand the disclose information about the research, and use this to make autonomous informed decision about participation, in line with their preferences and values. Yet the emergency context affects how information may be disclosed to prospective research participants, how much participants may comprehend, and how participants may express their voluntary decision to participate, all of which pose a threat to the validity of the informed consent. I challenge the claim that the ‘understanding’ of research is always necessary for ethical informed consent for research during emergency care. I argue for reconceptualization of the value of understanding, through recognition of other values that may be equally important. I then present a reflective perspective that frames moral reflection about autonomy, beneficence and justice in research in emergency research. Conclusion While participant ‘understanding’ of research is important, it is neither necessary nor sufficient for a valid informed consent, and may compete with other values with which it needs to be considered.

The ubiquity of mobile devices and the apps that power them has spurred concerns that they are contributing to the decline in news media use. Mobile devices, however, have been credited with spurring political participation. In its examination of app-reliant individuals, this study found that reliance on apps positively predicts political participation, and respondents who rely heavily on mobile apps for political information are more politically active than light app users on six of the seven measures of nononline participation and three of the six measures of online political activity. Heavy-reliant users also rely more heavily on all six online-only media tested than light app users and rely more heavily on broadcast television news, CNN, and news magazines. Data were collected from October 31, 2016, through November 2, 2016, from 644 respondents of a national online panel.

Griffiths’ (2017) response to the recent commentary piece by Ryding and Kaye (2017) on “Internet Addiction: A conceptual minefield” provided a useful critique and extension of some key issues. We take this opportunity to further build upon on one of these issues to provide some further insight into how the field of “internet addiction” (IA) or technological addictions more generally, may benefit from capitalising on behavioural data. As such, this response extends Griffiths’ (2007) points surrounding the efficacy of behavioural data previously used in studies on problematic gambling, to consider its merit for future research on IA or associated topics such as Internet Gaming Disorder (IGD) or “Smartphone addiction”. Within this, we highlight the challenges associated with utilising behavioural data but provide some practical solutions which may support researchers and practitioners in this field. These recent developments could, in turn, advance our understanding and potentially validate such concepts by establishing behavioural correlates, conditions and contexts. Indeed, corroborating behavioural metrics alongside self-report measures presents a key opportunity if scholars and practitioners are to move the field forward.

As mobile phones have evolved into Smartphones, they have become more than simple communication tools; transforming into personal assistants, entertainment devices and information gateways. There is a need to understand how this rapid transformation and complexity of Smartphone uses have impacted on users relationship with their phones. This study presents a thematic analysis of three focus group discussions around attitudes and experiences of owning and using Smartphones. Themes that emerged included a bifurcation in attitudes to Smartphones as simultaneously materialistic objects, and ones which users express anthropomorphic and sentimental views about. Participant accounts reflected the evolution of Smartphones from functional communication devices, to informational and recreational tools. Participants discussed using Smartphones to alleviate boredom and that device usage had become habituated for some users. However, context determined Smartphone use with some participants using them to feel secure while away from familiar settings. Participant accounts provide rich insights into different Smartphones uses and infer numerous implications for understanding why some users develop strong psychological attachments to them. Findings also imply that users may not be attached to the device itself, but rather the affordances on offer. The implications of these findings, for example in the assessment of Smartphone addiction, are discussed. Qualitative account of young people's attitudes and experiences of smartphone use.Smartphone described simultaneously in materialistic and anthropomorphic terms.Smartphones help users feel secure when away from their familiar, home setting.Sheds light on reasons why some people may become attached to their smartphones.

With Internet connectivity and technological advancement increasing dramatically in recent years, "Internet addiction" (IA) is emerging as a global concern. However, the use of the term 'addiction' has been considered controversial, with debate surfacing as to whether IA merits classification as a psychiatric disorder as its own entity, or whether IA occurs in relation to specific online activities through manifestation of other underlying disorders. Additionally, the changing landscape of Internet mobility and the contextual variations Internet access can hold has further implications towards its conceptualisation and measurement. Without official recognition and agreement on the concept of IA, this can lead to difficulties in efficacy of diagnosis and treatment. This paper therefore provides a critical commentary on the numerous issues of the concept of "Internet addiction", with implications for the efficacy of its measurement and diagnosticity.

Student satisfaction is both an important, yet controversial issue within the Higher Education sector, which is typically measured through policy-driven metrics such as the National Student Survey (NSS). However, less is understood about the qualities of a satisfying student experience “as lived” from the perspective of the student, thus questioning the adequacy of such measures. In response to this, the current study used student-driven photographic elicitation as a means of more adequately capturing the holistic student experience. This entailed nine final year undergraduate psychology students who each gathered a series of photos, which formed the basis for discussion in an interview. Thematic analysis of the narratives of the interview discussions revealed several main themes surrounding their experiences. These were: “Learning Environment”, “Work-Life Balance”, and “Wider University Community”. Findings are discussed with reference to the implications of student satisfaction, and national metrics used for measuring it, for institutional policies of recruitment and retention.

Research points to the positive impact that gender-segregated schooling and classroom initiatives exert on academic attainment. An evaluation of these studies which reveal positive effects highlights, however, that students are typically selectively assigned to single- or mixed-gender instructional settings, presenting a methodological confound. The current study controls for students’ prior attainment to appraise the efficacy of a single-gender classroom initiative implemented in a co-educational high school in the United Kingdom. Secondary data analysis (using archived data) was performed on 266 middle-ability, 11–12 year-old students’ standardized test scores in Languages (English, foreign language), STEM-related (Mathematics, Science, Information and Communication Technology), and Non-STEM subjects (art, music, drama). Ninety-eight students (54, 55% female) were taught in single-gender and 168 (69, 41% female) in mixed-gender classrooms. Students undertook identical tests irrespective of classroom type, which were graded in accordance with U.K national curriculum guidelines. Controlling for students’ prior attainment, findings indicate that students do not appear to benefit from being taught in single-gender relative to mixed-gender classrooms in Language and STEM-related subjects. Young women benefitted from being taught in mixed-gender relative to single-gender classes for Non-STEM subjects. However, when prior ability is not controlled for, the intervention appears to be effective for all school subjects, highlighting the confounding influence of selective admissions. These findings suggest that gender-segregated classroom initiatives may not bolster students’ grades. It is argued that studies that do not control for selection effects may tell us little about the effectiveness of such interventions on scholastic achievement. Electronic supplementary material The online version of this article (doi:10.1007/s11199-017-0799-y) contains supplementary material, which is available to authorized users.

Background: Contraceptive practices of perinatally HIV-infected adolescents (PHIAs) have implications related to pregnancy prevention, risks of HIV heterosexual transmission, reinfection, and vertical transmission. The study assessed contraceptive use among sexually active PHIAs in Uganda.\ud \ud Methods: Mixed methods consisting of a survey and in-depth interviews were employed among 213 sexually active PHIAs who were attending antiretroviral therapy (ART) clinics. The study was guided by Andersen's Behavioral Model of Health Service Use as a theoretical framework to identify factors that influence contraceptive use. These factors include health care factors, personal characteristics, enabling factors, and needs. The outcome was contraceptive use. Multivariable logistic regression was used to establish determinants of contraceptive use. Qualitative data were analyzed by thematic analysis.\ud \ud Results. Most PHIAs were female (67.6%); the mean (SD) and median (IQR) age was 17.5 (±1.4) and 18 (17-19) years. The mean age of sexual debut and at marriage were 15 (±1.7) and 17 (±1.1), respectively. Condoms were the most known method of family planning (indicated by 55.4%). Only 16.9% of the participants knew about dual protection (condom use for FP as well as HIV/STI prevention). Of the PHIAs, 43.6% had ever used modern contraception and 56.9% of the females had ever been pregnant. The odds of contraceptive ever-use were significantly higher among adolescents aged 17-19 years (OR 5.1, 95% CI: 2.1-13.3) compared to those aged 10-16 years, those in school (OR 1.8, 95% CI: 1.07-3.2) compared to those out of school, and those with perceived need to use FP (OR 2.0, 95% CI: 1.1-3.9) compared to their counterparts. The odds of contraceptive used were lower among females (OR 0.13, 95% CI: 0.06-0.28) compared to males. From the in-depth interviews, the attitude of health workers, availability of health workers, having a friend using family planning, and waiting time were viewed to affect contraceptive use.\ud \ud Conclusion. Contraceptive use among sexually active perinatally HIV-infected adolescents was (43.6%). However, out of those who used family planning majority were using short-term methods. The unmet need for family planning was high (47%) with high reports of pregnancy (56.9%). The factors associated with contraceptive use included education, age, sex (predisposing factors), and perceived need of family planning (need factors). Other factors that could affect contraceptive use from qualitative analysis included attitude of health workers, availability of health workers, having a friend using family planning (predisposing factors), and waiting time (health system factors). HIV care for adolescents should be promoted using SRH approach. There is a need to provide training for all providers to cater for SRH services. We should continue to provide youth-responsive adolescent sexual and reproductive health services across all ART facilities and build a supportive environment and continue to integrate SRH services into HIV care.

Retweeting is not simply to get messages out to new audiences, but also to validate and engage with others. Using a content analysis of 3,429 tweets about the South Korean Anti-Terrorism Act of 2016, this study finds that the tweets created by civil society, political actors, and mass media/journalists are more likely to be retweeted than the tweets written by ordinary individuals, suggesting the role of heuristic strategy. This study also finds that content factors influence retweeting. Emotionally toned tweets are more likely to be retweeted, and rationality of tweets moderates the association between author types and retweeting.

This study has four primary purposes: to investigate the level of interactivity with 15 sources of political information, determine the degree of reliance on each of the sources, assess perceptions of credibility, and compare the strength of interactivity to the strength of reliance on judgments of credibility. This study includes sources that have received little attention in the credibility literature such as social network sites, Twitter, and mobile device applications. Respondents interact with and rely on the sources moderately. Credibility ratings range from moderate to highly credible. Reliance predicts credibility of 14 of 15 sources as compared to interactivity that predicts credibility of just 9 of 15 sources. Interactivity with sources that are inherently collaborative (e.g. Twitter, social media, talk radio) more strongly predicts credibility than interactivity with sources that are more source-to-user based (e.g. CNN, political websites). This study explores credibility of 15 sources of political information including mobile device apps.The six most credible sources are all traditional media.Fox News, Twitter and candidate blogs are judged the least credible sources.Reliance is a much better predictor of credibility than interactivity.Interactivity predicts credibility better with collaborative sources (e.g. social media).

This chapter outlines player demographics associated with digital games through the lens that gaming can comprise four key facets: function, content, platform, and context. This defining of demographics is important, because if gaming is considered a generic entity, it is difficult to establish specific nuances to determine a valid account of player demographics. As such, this chapter provides an account of player demographics and how these may vary as a product of these different facets. It also highlights the issues and challenges associated with this endeavor. Finally, it presents a conceptual model that underpins these issues, whereby these facets of gaming may be determined by gaming domains and play formats.

The introduction of the new UK tuition fees resulted in concerns about the impact on higher education (HE) uptake, and raised questions regarding students’ motivations for attending university. The current study explored first-year undergraduate psychology students’ (N = 56) reasons for attending HE through a series of focus groups. These were undertaken both before (n = 21) and after (n = 35) the rise in fees, providing a pre–post comparison of potential changes. Results from the pre-fee rise sample showed that general reasons for attending HE reflected wider, contextual factors, drawing on socio-cultural influences. However, the post-fee rise data suggested that HE uptake was largely motivated more by career opportunities associated with degree-level education. Similarly, reasons for choosing psychology-based courses was related to vocational interest, suggesting strategic decision-making processes of students embarking on HE. The findings present new evidence of the role of financial investment in HE on general and course-specific motivation. Implications of the findings are discussed, with particular reference to the development of relevant employability initiatives within HE curricula.

Traditional media are perceived as more credible than Twitter, Facebook and blogs.Respondents judged fair and balanced sources as more credible than ones that take positions.Traditional media credibility scores suggest they are not living up to user expectations.Social media users are willing to give up credibility if the sources meet their needs. One question that has troubled credibility researchers is why do people rely on media that they do not deem credible? This question has also arisen with the coming of social media, which is increasingly relied on for news and information despite its low credibility ratings. This study compares perceptions of credibility of political information found on Facebook, blogs, and Twitter to credibility of information found on traditional media and it investigates if credibility ratings influence motives for using social media for political information. This study found that all traditional media except Fox News were rated more credible than social media sites, which suggests that sources that strive to present news that is fair and unbiased are judged more credible. But traditional news sources are only rated as moderately credible, which indicates that they are not measuring up to the standards of journalistic integrity. Credibility of social media consistently influenced motivations for using them, suggesting that gratifications obtained from these sources may be strong enough that users are willing to trade credibility for need satisfaction.

Introduction: Knowledge of a person’s HIV status during pregnancy is critical for prevention of mother to child transmission of HIV.Objectives: To determine the prevalence and factors associated with unknown HIV status among women delivering in Mulago Hospital.Methods: This was a cross-sectional study of women that had just delivered. The women’s demographic characteristics, health seeking behaviour, health system-related factors and knowledge on PMTCT were collected. Fisher’s exact test, Wilcoxon rank sum test and logistic regression were used to test associations.Results: The prevalence of unknown HIV status was 2.6% (10/382). Attending ANC at higher level facilities (OR =0.1 95% CI 0.0 – 0.4) and having been counselled for HIV testing during ANC (OR=0.1, 95% CI 0.0 - 0.4) were associated with likelihood of having a known HIV status. Out of the ten women with unknown HIV status, 4/6 who attended ANC in public/ government accredited health facilities “opted out” of HIV testing due to personal reasons. Among the four who attended ANC in private clinics, two were not offered HIV testing and one “opted out”.Conclusion: Most participants had a known HIV status at labour (97%). Private clinics need to be supported to provide free quality HCT services in ANC.Keywords: Unknown HIV status, women delivering, Mulago National Referral Hospital, Kampala, Uganda

Introduction: Perinatally HIV-infected adolescents have the right to healthy sexual and reproductive lives like their HIV uninfected counterparts. The study assessed the quality of care of sexual and reproductive health (SRH) services in antiretroviral therapy (ART) clinics attended by perinatally-infected HIV adolescents. Methods: The study was guided by Judith Bruce and Anrudh Jain framework for conceptualizing quality as “client-oriented” care. Qualitative and quantitative methods were used to assess quality of care. We conducted facility assessment, evaluation of providers' perspectives regarding the quality of SRH care, and evaluation of experiences of perinatally-infected HIV adolescents about the quality of SRH care provided in the ART clinics. We conducted 24 in-depth interviews with adolescents and 12 interviews with service providers. Furthermore, a survey of 624 adolescents aged 10-19 y was conducted, where information on socio-demographic profiles and access and utilisation of RH services were collected. Survey data was analysed descriptively to provide frequencies and percentages while qualitative data was analyzed by content analysis. Results: Most adolescents (84.5%) were dissatisfied with SRH services provided by the clinics. None of the ART clinics offered comprehensive SRH services, which limited choices of clients. All units offered SRH information and education except post-abortion care and mental health. Only three units had trained their staff in SRH and adolescent friendly services which impacts on technical competence of the service providers in provision of SRH services. The structure of the clinics was based on adult and pediatric care implying there were no adolescentspecific services. Conclusion: The lack quality of care of SRH services in ART clinics is both an organisational and resource issue. For health systems to achieve universal access to high-quality sexual and reproductive health the ART clinics is dependent on rational decisions regarding investments in and allocation of human resources for health. There is need for in-service training of Health Workers in adolescent health. The Ministry of Health needs to engage partners for support to increase the numbers of health facilities which are adolescent friendly.

Since their popularization, video games have developed a reputation for being antisocial spaces. However, this is somewhat contrary to the wealth of social opportunities and functions which contemporary gaming offers, as well as what much of the research in the area suggests. This chapter will outline the key claims and draw on research findings from the academic literature, in order to debunk much of these anecdotal and old-fashioned conceptualizations of what gaming is and who gamers are. This will include a discussion of the various ways in which gaming can be experienced socially, the effects of social play, and how these effects may vary depending on the specific type of game and context of play.

This article investigates whether Twitter use motivations relate to exposure to discordant information. To this end, this research conducted an online survey of 1,350 adults of South Korea. The results reveal that using Twitter for information-seeking, public-expression, and leisure-seeking purposes helps users to encounter crosscutting exposure, while the use of Twitter for private expression does not. Offline network diversity has a significant association with crosscutting exposure, and it moderates the relationship between Twitter use for public expression or leisure seeking and crosscutting exposure. The positive association between Twitter use for leisure seeking and crosscutting exposure is stronger among younger people than among older people.

In view of recent changes in the higher education sector, such as increased tuition fees, a greater focus has been placed on widening participation initiatives and monitoring student satisfaction. The aims of the current study were twofold: (1) to explore whether pre-entry programmes foster successful transition to higher education, and (2) to examine longitudinally the factors associated with course satisfaction. Eighty-eight first-year psychology students completed a questionnaire measuring academic self-efficacy, social identity and student satisfaction at the start (Time 1, November 2015) and end (Time 2, March 2016) of the academic year. Findings indicated that students who participated in a pre-entry programme reported higher academic self-efficacy and satisfaction compared to typical route students. Moreover, academic self-efficacy predicted student satisfaction at the start of the academic year, whereas in-group affect (a facet of social identity) predicted this at the end of the academic year. The current findings indicate that pre-entry programmes may have a positive impact on students’ sense of academic self-efficacy. On a more general level, the findings also suggest that academic self-efficacy and social identity may be key indicators of student satisfaction. This highlights the complexities of the concept of ‘student satisfaction’, and demonstrates the utility of examining multiple factors relating to student satisfaction across different time points.

Background In the last decade, Makerere University College of Health Sciences (MakCHS) has taken strides in research and training to improve healthcare through collaborative training and research programs. However, there is limited data on the trends of MakCHS faculty contributions to research and on faculty growth to take leading roles in health research. This paper reviews MakCHS faculty research publications over 15.5 years and outlines possible strategies to enhance faculty research outputs. Methods We used a mixed methods approach. A systematic review of research publications by faculty at MakCHS (PubMed and Google Scholar from January 1, 2000, to June 30, 2015) to quantify the number of research articles, areas researched, authorship contribution by MakCHS faculty, source of funding, as well as affiliated local and international collaborations. Graphs were used to shown trends in publications and leadership of authorship by faculty. Annual individual faculty research productivity was presented as publication per capita. Qualitative data on high priority needs to improve research outputs was collected through focus group discussions (FGDs) with faculty members, and analysed manually into emerging themes. Results Of 298 faculty at MakCHS at 2015, 89 (30%) were female and 229 (77%) were junior and mid-level faculty (senior lecturer and below). The PubMed and Google Scholar searches yielded 6927 published articles, of which 3399 (49%) full-text articles were downloaded for analysis, 426/3825 (11%) available as titles/abstracts only, and 598/4423 (14%) were excluded. Only 614 articles were published in 2014, giving a publication per capita of 2.1 for any authorship, and 0.3 for first and last authorship positions. MakCHS faculty increasingly contributed as first, second, third, and last authors. Up to 57% of research was in infectious diseases, followed by non-communicable diseases (20%) and non-communicable maternal child health (11%). Priority needs to improve research outputs, as expressed by faculty, were (1) an institutionally led faculty career development program, (2) skills building in research methods and scientific writing, (3) protected time for research related activities, (4) opportunities for collaborative research, and (5) use of individual development plans. Conclusion Faculty research productivity was low and dominated by infectious diseases and non-communicable disease research. There is a need for structured institutional support to optimise faculty research outputs. Only with increased research productivity will MakCHS and other academic institutions be able to make a significant contribution in addressing national health challenges. Electronic supplementary material The online version of this article (doi:10.1186/s12961-017-0196-6) contains supplementary material, which is available to authorized users.

Objective To gain an understanding of how obstetric complications affect the lives and livelihoods of survivors. Methods A phenomenological study was conducted between April and August 2013 at Mulago Hospital, Kampala, Uganda. Data were collected through in-depth interviews among 36 women admitted with obstetric near miss. The interviews investigated perceptions, lived experiences, and meanings attached to such experiences by survivors. More specifically, the questions explored: self-rated health; anticipated social, sexual, and reproductive health challenges; and mitigating factors. Results The identified themes were prior expectations, vulnerability, body and social capital, and resilience. Women were found to approach childbirth with predetermined expectations that influenced their pregnancy and childbirth experience. Fatalism, expectations, and social insecurity markedly contributed to vulnerability. Resilience factors included ability to institute adaptations and to harness body and social capital. Conclusion Vulnerabilities and their determinants were found to be inter-related. Individuals’ social capital fluctuates over the acute crisis, necessitating multiple adaptations and coping strategies to reduce vulnerability or increase resilience. Although social and body capital may be mobilized to mitigate the effects of the obstetric crisis, they can either worsen vulnerability or increase resilience.

The rise of social media, such as blogs, social network sites, Twitter, and YouTube, encourages hope for renewed confidence in the government and news media because these venues connect users directly to candidates and officeholders. This article indicates that blogs most heavily relied on the type of social media for political information. Moreover, reliance on blogs and YouTube leads to reduced confidence in the presidency, Congress, and the news media, but reliance on social network sites and Twitter leads to higher confidence in these institutions after controlling for strength of party ties, political ideology, political interest, reliance on traditional media, and demographic variables.

The emergence of social media as a new channel for communication and collaboration has led educators to hope that they may enhance the student experience and provide a pedagogical tool within Higher Education (HE). This paper explores academics’ and undergraduates’ usage of Twitter within a post-92 university. It argues that the observed disparity of usage between academics and undergraduates can be attributed to a number of factors. Namely, academics’ perceived use of the platform for enhancing reputation is an implied acknowledgement of the importance of research within HE and the increasingly public engagement agenda. Additionally, academics’ limited usage of Twitter to support practical-based issues may be explained by issues relating to accountability of information through non-official channels. Moreover, students made greater use of Twitter for the passive reception of information rather than participation in learning activities. The implications of these issues will be discussed in reference to th...

Scholars have confirmed that political candidates are increasingly turning to social network sites SNS to persuade voters to vote for them, and that these sites have become prominent sources of political information. But a fundamental question arises about the sustainability of social networks as a campaign tool: How much do users trust the information they find there? This study employed an online survey to examine the degree to which politically interested online users view SNS as credible. SNS were ranked the least credible among the nine traditional and online sources examined. Reliance on social networks proved the strongest predictor of SNS credibility.

This study investigated what sources were relied on to find out about Osama bin Laden's death and whether perceptions of credibility and political party affiliation influenced these media choices. The most striking difference in media reliance for bin Laden news was that whatever sources Tea Partiers relied on and thought credible were those that Democrats did not rely on or see as credible. Despite the clamor about how quickly news flows through social network sites and Twitter, only about 5% of respondents first heard about bin Laden through these sources and a slightly larger percentage spread the news via these tools. Moreover, social network sites and Twitter were the least relied on about the aftermath of bin Laden's death.

Objective: Women’s preferences for the mode of delivery provide clues on their knowledge and perceptions of anticipated risk of childbirth complications. The objective was toinvestigate incongruence between preferred mode of delivery and risk of adverse pregnancy outcomes. Methods: Through a cross-sectional study, data were collected from 327 women admitted to Mulago hospital. Data included socio-demographic characteristics, past medical, gynaecological and obstetric history, pregnancy complications, knowledge of pregnancy complications and preferred mode of delivery. The preferred mode of delivery and knowledge of related risks for adverse pregnancy outcomes were compared. Results: The mean age of participants was 24.7 years (±5.9), ranging 14 - 43 years, of whom 41.4% were nulliparous. The preferred mode of delivery was vaginal (84.1%). Incongruence (preference for a mode of delivery that did not correspond to expected or anticipated risks) occurred in 88 (26.9%) of the women, and was associated with having secondary school or higher level of education (OR 2.49, CI 1.52 - 4.08) and history of previous vaginal delivery (OR 3.82, CI 1.94 - 7.49). Conclusion: One in four women had incongruence between preferred mode of delivery and risks of adverse pregnancy outcomes, which called for urgent interventions to improve decision-making about intrapartum care.

This study focused on whether reliance on specific online media predicted support for Barack Obama or John McCain during the 2008 presidential election. Political blogs and political websites were the most heavily relied on sources for election news. Moreover, preference for Obama was positively predicted by reliance on social network sites, online newspapers, online newsmagazines, and candidate sites, and negatively predicted by reliance on political blogs. In contrast, support for McCain was positively predicted by reliance on online cable television news and negatively predicted by reliance on social network sites, online newspapers, online newsmagazines, and online candidate sites. Reciprocal relationships were also found in which media reliance predicted candidate preference and candidate preference predicted media reliance.

Chirurgische Facelift-Techniken haben seit mehr als 20 Jahren ihren festen Platz in modernen Gesichtsverjungungskonzepten. Vielfaltige Techniken sind beschrieben worden. Die Tendenz der letzten zehn Jahre geht zu weniger invasiven Eingriffen und naturlichen Resultaten, die ein verjungtes, kein uberstrafftes Gesichtsbild vermitteln. Essenzieller Teil einer Gesichtsverjungung ist die Verjungung bzw. Erneuerung des Hautbildes, welches entscheidend zum Gesamteindruck beitragt. Die reine Repositionierung der Gesichtsvolumina und das Straffen einer gealterten Haut konnen keine umfassende und uberzeugende Verjungung erreichen. Fachubergreifende Kombinationstechniken dienen zur Erweiterung der Indikation des Facelifts und zur Verbesserung des asthetischen Outcomes. Ziel dieses Artikels ist es, Moglichkeiten und Grenzen von zeitgleich mit einer Gesichtsstraffung durchzufuhrenden Hautverjungungstechniken anhand des adjuvanten Einsatzes verschiedener Peelingtechniken und des autologen Fetttransfers im Rahmen unseres P.A.V.E.(„peeling assisted volume enhancing“)-Lift-Konzepts sowie die Effizienz und Sicherheit eines solchermasen erweiterten Behandlungsansatzes aufzuzeigen.

This article presents baseline data from the SASA! (this is the Swahili for ‘now’) Study, a cluster randomized trial of a community-mobilization intervention to prevent violence against women and HIV/AIDS in Kampala, Uganda. Logistic regression was used to explore associations between intimate partner violence (IPV) and sexual risk behaviors, among 1,206 ever-partnered men and women (18-49 years). Twenty-seven percent of women reported past-year experience of physical and/or sexual IPV. Female experience and male perpetration of IPV were strongly associated with sexual risk behaviors. Findings confirm the importance of the SASA! intervention in this setting and endorse integrated strategies for IPV and HIV prevention.

We live in a digital society that provides a range of opportunities for virtual interaction. Consequently, emojis have become popular for clarifying online communication. This presents an exciting opportunity for psychologists as these prolific online behaviours can be used to help reveal something unique about contemporary human behaviour.

Background Obstructed labour remains a major cause of maternal morbidity and mortality whose complications can be reduced with improved quality of obstetric care. The objective was to assess whether criteria-based audit improves quality of obstetric care provided to women with obstructed labour in Mulago hospital, Uganda. Methods Using criteria-based audit, management of obstructed labour was analyzed prospectively in two audits. Six standards of care were compared. An initial audit of 180 patients was conducted in September/October 2013. The Audit results were shared with key stakeholders. Gaps in patient management were identified and recommendations for improving obstetric care initiated. Six standards of care (intravenous fluids, intravenous antibiotics, monitoring of maternal vital signs, bladder catheterization, delivery within two hours, and blood grouping and cross matching) were implemented. A re-audit of 180 patients with obstructed labour was conducted four months later to evaluate the impact of these recommendations. The results of the two audits were compared. In-depth interviews and focus group discussions were conducted among healthcare providers to identify factors that could have influenced the audit results. Results There was improvement in two standards of care (intravenous fluids and intravenous antibiotic administration) 58.9 % vs. 86.1 %; p

Introduction: Acquisition of sexually transmitted infections (STIs) is an epidemiological marker of high-risk sexual behavior in HIV-infected patients. We assessed the prevalence of STIs among patients attending an HIV care and support centre. Methodology: From January to August 2009, we assessed socio-demographic variables, sexuality, disclosure of sero-status and STI treatment for 400 patients attending the HIV care and support centre. Characteristics of those who had been treated and those who had never been treated for STIs were compared to identify factors independently associated with STIs. Results: Of the 400 respondents, 25.3% were male, 47.3% were aged 25-34 years, over 85% were currently married or had ever been married, and 62% had primary level of education or less. Though 82.5% were on antiretroviral drugs, only 53.1% disclosed their sero-status to their regular partners and only 41.9% knew the sero-status of their regular partners. Furthermore, 151 (37.7%) had been treated for STIs. The STIs were gonorrhoea (15; 9.7%), chlamydia (11; 7.1%), Trichomonas vaginalis (5; 3.3%), syphilis (99; 64.3%), and mixed infections (21; 13.6%). Factors associated with STI treatment on univariable analysis were age at sexual debut, whether the respondent had had sex in the previous six months, frequency of sexual intercourse, having changed sexual partners, number of sexual partners, and age when the respondent had a first child. Conclusion: Unprotected sexual intercourse and STIs are common among patients seeking HIV care in Uganda. Only the age of sexual debut (odds ratio0.82, confidence limits 0.71, 0.94) was independently (though inversely) associated with STIs.

Globally, HIV sero-discordance is a major public health problem, due to increased risk of HIV transmission to HIV-negative partners. From January to August 2009, we assessed the sexual behaviour of HIV-infected patients attending an HIV treatment centre in Uganda and analysed characteristics associated with HIV sero-discordance. Of the 278 respondents, 256 (92.1%) were female, 218 (78.1%) were on antiretroviral drugs and 107 (38.7%) belonged to a sero-discordant couple. In the prior 3 months, 238 (88.5%) had more than one sexual partner and 98 (35.8%) had acquired new sexual partners. Only 171 (61.5%) had ever disclosed sero-status to main sexual partners. Participants who had changed sexual partners in the previous 3 months were more likely to be sero-discordant (OR 1.87, 95% CI 1.13, 3.11). Respondents who used condoms during their last sexual intercourse and those currently on ARVs were significantly less likely to be sero-discordant (OR 0.52 95% CI 0.28, 0.96 and OR 0.52 95% CI 0.30, 0.94, respectively). Only disclosure of sero-status was independently though inversely associated with discordance (adjusted OR 0.41, 95% CI 0.20, 0.64). Our findings indicate that HIV patients continue exhibiting high risk behaviour characterised by changing sexual partners, having multiple sexual partners and non-use of condoms.

Information and communication technology (ICT) has been advocated as a powerful tool for improving health education in low-resource settings. However, few evaluations have been performed of ICT perceptions and user experiences in low-resource settings. During late 2009, an internet-based survey on ICT was administered to students, tutors, and faculty members associated with a Community-Based Education and Service (COBES) program in Uganda. 255 surveys were completed. Response rates varied (students, 188/684, 27.5%; tutors, 14/27, 51.9%; faculty, 53/335, 15.8%). Most respondents owned mobile phones (98%). Students were less likely (p < 0.001) to own laptops (25%) compared to tutors (71%) and faculty (85%). Internet access at rural sites was uncommon; mobile phone coverage was almost universally present. Laptop ownership and internet and mobile phone access was not associated with high valuation of students' COBES experiences. Free text responses found that respondents valued ICT access for research, learning, and communication purposes. In summary, ICT penetration in this population is primarily manifest by extensive mobile phone ownership. Internet access in rural educational sites is still lacking, but students and educators appear eager to utilize this resource if availability improves. ICT may offer a unique opportunity to improve the quality of teaching and learning for COBES participants.