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Background: Motor development of many children in rural areas of South Africa is compromised because of various socio-economic factors, hence, the need to address these developmental needs. Aim: To examine the immediate and sustainable effects of a 9-week movement programme on fundamental movement skills (FMS) of school children. Setting: Seven to eight years old school children in Raymond Mhlaba Municipality, Eastern Cape province. Methods: A two-group, pre-post-re-test research design was used. Fundamental movement skills (FMS) proficiency was assessed using the Test of Gross Motor Development-Third Edition (TGMD-3) at pre-test, post-test and re-test after 6 months. Ninety-three school children (intervention group [IG] = 57) and (control group = 36), with a mean age of 7.12 (± 0.71) participated in the study. The twice-a-week FMS programme of 30 min was conducted during school hours. Statistical analysis included an ANOVA type of hierarchical linear model (HLM) (mixed models) procedure to test for intervention effects with school, time, sex and group as covariants. Cohen's effect size was calculated to assess the practical significance of changes. Results: Immediate and sustainable effects were found on locomotor (p < 0.05; d > 1.7, p < 0.05; d > 2.0), ball skills (p < 0.05; d > 0.7, p < 0.05; d > 1.5) and the gross motor index (GMI) of the IG (p < 0.05; d > 1.0, p < 0.05; d > 2.0). Conclusions: A short-duration FMS intervention significantly improve locomotor, ball skills, and GMI of school children in rural areas. Contributions: Interventions of this nature are encouraged to improve the FMS development of school children, especially in rural areas, as it can enhance the building blocks required in the future development of these children.

Purpose: The purpose of this study was to identify the transformation disclosures in the publicly available annual reports of South African public universities and to establish the extent to which universities account to their stakeholders about how they have discharged their transformation obligations. Design/methodology/approach: This exploratory qualitative study involves a thematic content analysis of publicly available annual reports using ATLAS.ti software to identify and categorise transformation interventions disclosed by South African public universities. Findings: This empirical study identifies several interventions that universities have introduced to facilitate access to and successful completion of tertiary studies by students. Some of the disclosed mechanisms include the provision of financial aid, student support and counselling, tutoring and mentoring and ICT enhancements and the introduction of language policies. The results also highlighted several challenges to sustainable transformation including funding, social and academic barriers and infrastructural challenges experienced by universities. Originality/value: According to the authors' knowledge, this study represents one of the first studies to use the public disclosures in the annual reports of public universities to identify interventions introduced to facilitate transformation of the student body. Despite its South African orientation, the observations have implications for universities worldwide experiencing similar challenges, especially in developing countries.

The purpose of the study was to explore how a school-based training model (SBTM) could help to address the shortage of teachers. This model also allows, among other aspects, for poor and disadvantaged students to study while they gain experience. This article reports on the results of the SBTM implemented by a South African university, whereby student teachers are appointed at schools as assistant teachers. A mixed method study was preferred in order to explore the effectiveness of the model. The findings of the research indicate that the majority of teachers, lecturers, students and members of school managements involved were positive regarding the SBTM, and that the advantages of the model outweighed the challenges. It is therefore recommended that the model be implemented as an alternative teacher training programme for the special conditions prevailing in South Africa, as well as other countries that experience a teacher shortage.

We report research into associations between the school-level and classroom-level environment in science classrooms in South Africa. An instrument, developed to assess students' perceptions of their classroom learning environment as a means of monitoring and guiding changes towards outcomes-based education, was administered to 2,638 Grade 8 science students from 50 classes in 50 secondary schools in Limpopo province. In addition, the teachers of each of the 50 classes responded to a questionnaire developed to assess factors in the school-level environment (such as the adequacy of resources, parental involvement and collegiality). The data collected using the two questionnaires were analysed to examine whether the environment created at the school level was linked to the likelihood of teachers successfully implementing outcomes-based education at the classroom level.

We examined the viability of using feedback from a learning environment instrument to guide improvements in the teaching practices of in-service teachers undertaking a distance-education programme. The 31 teachers involved administered a primary school version of the What Is Happening In this Class? (WIHIC-Primary) questionnaire to their 1,077 learners in order to determine preferred and actual classroom environments. Feedback about discrepancies between learners' actual preferred learning environments were used to formulate teaching strategies to reduce discrepancies over a 12-week intervention period. In-service teachers' reports, contact sessions, interviews between teachers and researchers, and three case studies based on classroom visits (one of which is reported here) provided thick descriptions of teachers' reactions to utilising the learning environment instrument. Our research provided the first learning environment study at the primary school level in South Africa, cross-validated an IsiZulu version of the WIHIC when used for the first time in South Africa, and supported the success of teachers' use of a learning environment questionnaire in guiding improvements in their teaching.

Responding to calls to incorporate biodiversity matters into accounting research, we attempt to provide a balance by moving away from the conventional focus on the reporting of biodiversity impacts and activities by public and private sector organisations, by focusing on how non‐governmental organisations active in the conservation space (CNGOs), interact with the public sector. In particular, we confine our study to explaining how South African state‐owned enterprises (SOEs) and CNGOs active in South Africa, report on their collaboration engagements. To explain the engagements between SOEs and CNGOs, we use their publicly available reports (annual/integrated) to explore the extent which these entities interact and collaborate. However, although several CNGOs operate in South Africa, we documented little evidence of formalised engagements between these SOEs and CNGOs, with Eskom being the notable exception. Notwithstanding the observed scant formalised reporting on engagements, we suggest that the reporting of CNGOs engagements could be harnessed to indirectly serve as alternative credibility enhancing mechanisms. In this way, it could contribute by attesting to the veracity of organisational biodiversity disclosures, and may provide a basis to hold these organisations to account for their contribution to environmental conservation, or degradation. In this context, we conclude by calling for a research agenda to investigate the relationship between CNGOs and their funding organisations, irrespective of whether they operate in the public or private sectors, as well as the potential of CNGOs to serve as advocacy and activism agents, thereby improving organisational biodiversity accountability. [ABSTRACT FROM AUTHOR]

This brief commentary explores the opportunities and challenges presented by the increasing prevalence of artificial intelligence in the field of psychology in South Africa. Artificial intelligence has the potential to revolutionise teaching and learning, research, content production, and professional services, but it also presents some challenges to academic and professional psychology in South Africa. While some generative artificial intelligence can produce written work, such as assignments, literature reviews, and theses, they currently cannot replace human reasoning and the critical thinking abilities required to argue a particular point (at this stage). Artificial intelligence chatbots can also act as teaching assistants and even provide complex psychological interventions such as cognitive-behavioural therapy. In research and publication, artificial intelligence can increase efficiency and provide new insights and perspectives by detecting patterns and relationships that may have been overlooked by human researchers. However, the use of artificial intelligence raises ethical concerns, particularly around ownership and authorship of artificial intelligence–generated content, potential biases, and errors. The commentary concludes that as artificial intelligence technology continues to evolve, and with the human–artificial intelligence partnership continuing to unfold, it is important to recognise the risks associated with its use in academic writing and ensure that psychology students develop appropriate research skills. [ABSTRACT FROM AUTHOR]

Concerns remain about how companies will reconcile environmental, social and governance (ESG) issues with their core mandates. This is one reason why many organisations did not initially subscribe to sustainable investing, reporting and accounting, especially where it is not mandatory, despite growing stakeholder pressure to do so. This paper examines how state‐owned enterprises (SOEs) with social and commercial mandates in South Africa, where sustainability reporting is mandatory, balance ESG practices and financial sustainability to fulfil their mandates. This article proposes and evaluates propositions about SOEs adopting and reporting ESG components using a survey questionnaire and semi‐structured interviews with important SOE stakeholders to show that its sustainability accounting approach benefits policy and non‐policy observers. More than half of the studied SOEs have embraced and disclosed their ESG practices, yet there appears to be no systematic way in which they balance ESG practices and financial sustainability, resulting in conflict. This paper appears to be the first SOE study on this topic. In this regard, this study offers novel insights into how sustainability practices may be incorporated into the social and commercial objectives of SOEs, which in most cases are conflicting, while still allowing SOEs to be financially sustainable and depend less on state bailouts, which is often the case, especially in Africa and in countries that face a high level of corruption. Considering the characteristics and mandates of SOEs, part of being socially responsible is utilising public resources in the form of taxpayers' money in an efficient, effective and accountable manner. The discussion in this paper indicates that paying attention to ESG issues is part of a broader accountability mechanism expected from SOEs. Also, the choice of South Africa and of SOEs in South Africa has implications for theory and practice since SOEs in South Africa have social and commercial objectives such that they are expected to be agents of social responsibility. [ABSTRACT FROM AUTHOR]

Background: Evidence-based medicine (EBM), as originally conceived, used all types of peer-reviewed evidence to guide medical practice and decision-making. During the SARS-CoV-2 Coronavirus disease (COVID-19) pandemic, the standard usage of EBM, modeled by the Evidence-Based Medicine Pyramid, undermined EBM by incorrectly using pyramid levels to assign relative quality. The resulting pyramid-based thinking is biased against reports both in levels beneath randomized control trials (RCTs) and those omitted from the pyramid entirely. Thus, much of the evidence was ignored. Our desire for a more encompassing and effective medical decision-making process to apply to repurposed drugs led us to develop an alternative to the EBM Pyramid for EBM. Herein, we propose the totality of evidence (T-EBM) wheel. Objectives: To create an easily understood graphic that models EBM by incorporating all peer-reviewed evidence that applies to both new and repurposed medicines, and to demonstrate its potential utility using ivermectin as a case study. Methods: The graphics were produced using Microsoft Office Visio Professional 2003 except for part of the T-EBM wheel sunburst chart, which was produced using Microsoft 365 Excel. For the case study, PubMed® was used by searching for peer-reviewed reports containing "ivermectin" and either "covid" or "sars" in the title. Reports were filtered for those using ivermectin-based protocols in the treatment of COVID-19. The resulting 265 reports were evaluated for their study design types and treatment outcomes. The three-ringed graphical T-EBM wheel was composed of two inner rings showing all types of reports and an outer ring showing outcomes for each type. Findings-Conclusions: The T-EBM wheel avoids the biases of the EBM Pyramid and includes all types of reports in the pyramid along with reports such as population and mechanistic studies. In both early and late stages of medical emergencies, pyramid-based thinking may overlook indications of efficacy in regions of the T-EBM wheel beyond RCTs. This is especially true when searching for ways to prevent and treat a novel disease with repurposed therapeutics before RCTs, safety assessments, and mechanisms of action of novel therapeutics are established. As such, T-EBM Wheels should replace the EBM Pyramids in medical decision-making and education. T-EBM Wheels can be expanded upon by implementing multiple outer rings, one for each different kind of outcome (efficacy, safety, etc.). A T-EBM Wheel can be created for any proprietary or generic medicine. The ivermectin (IVM) T-EBM Wheel displays the efficacy of IVM-based treatments of COVID-19 in a color-coded graphic, visualizing each type of evidence and the proportions of each of their outcomes (positive, inconclusive, negative). [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic, which has been primarily analysed within urban contexts, has revealed a significant gap in understanding its ramifications within rural areas. This study aims to address this gap by drawing upon the principles of Resilience Theory to shed light on the repercussions of the pandemic in rural contexts, thereby highlighting an overlooked aspect. This research employs a qualitative paradigm grounded in primary data collected from two rural municipalities, Matatiele and Winnie Madikizela Mandela Local Municipalities, in South Africa's Eastern Cape Province. The primary data is derived from 11 focus group interviews involving essential stakeholders and 13 individual interviews that were purposefully selected. The study unravels a spectrum of adverse impacts from the COVID-19 pandemic across the two municipalities by thematically transcribing and coding audio records of interviews and focus groups using NVivo, employing inductive and deductive coding approaches. These impacts include employment loss, bereavement, food insecurity, and an upsurge in reported cases of gender-based violence. The pandemic's ripples extend to cultural practices, education, and community well-being, as evidenced by the waning participation in cultural traditions, declining interest in education among school-goers, and a surge in substance abuse and criminal activities like stock theft. In light of these findings, the study advocates for customised pandemic responses in rural areas underpinned by the Resilience Theory framework. This entails endorsing enhanced healthcare infrastructure, fostering community-driven surveillance, promoting diversified livelihood strategies, and bolstering local governance structures. As the study expands our understanding, it concurrently underscores the significance of further exploration. The proposed avenue of research lies in examining how collaborative efforts among rural-based institutions can augment community resilience against the dual challenges of pandemics and disasters. Through this lens, the study emphasises the imperative of building adaptive capacity within rural communities, emphasising their ability to navigate uncertainties and emerge stronger in adversity. [ABSTRACT FROM AUTHOR]

Environmental management systems implemented in schools are regarded by many as a mechanism for the integration of environmental matters in all the operational functions of the school. The links, however, between environmental management and curriculum practice have not been adequately addressed in the literature. This article reports on the results of a project aimed at integrating pedagogical aspects in environmental management systems in 60 primary Kanyimba, Richter and Raath The integration of pedagogical aspects schools in four provinces of the Republic of South Africa over a period of two years. A baseline survey and post-baseline surveys assessed the integration of pedagogical aspects in environmental management systems. The data were evaluated with the aid of Cohen's effects sizes. The results show that primary schools in this case study had succeeded in developing environmental management structures as part of the overall school management system. The pedagogical aspects, however, were not successfully synchronised with the environmental management systems. The study identified an unrealised potential to link environmental management systems to curriculum practice and suggests opening a two-way conversation between environmental management systems and actual delivery of instructional content. It is suggested that existing learning connections that are present in neighbourhoods, such as outdoor classrooms, be harnessed to assist in the development of values and attitudes of teachers and learners.

Skeletal remains discovered in Simon's Town, South Africa, were hypothesised as being associated with a former Dutch East India Company (VOC) hospital. We report a novel combined osteological and biochemical approach to these poorly-preserved remains. A combined strontium (87Sr/86Sr), oxygen (δ18OVPDB) and carbon (δ13CVPDB) isotope analysis informed possible childhood origins and diet, while sex-specific amelogenin enamel peptides revealed biological sex. Osteological analyses presented evidence of residual rickets, a healed trauma, dental pathological conditions, and pipe notches. The combined isotope analyses yielded results for 43 individuals which suggested a diverse range of geological origins, including at least 16% of the population being non-local. The inclusion of δ13CVPDB had intriguing implications for three individuals who likely did not have origins in the Cape Town region nor in Europe. Peptide analysis on the dental enamel of 25 tested individuals confirmed they were all biologically male. We suggest that isolated enamel may provide crucial information about individuals' pathological conditions, geographical origins, diet, and biological sex. These data further demonstrated that a combined approach using multiple osteological and biochemical methods is advantageous for human remains which are poorly preserved and can contextualise a site with little direct evidence. [ABSTRACT FROM AUTHOR]

Investigations of abiotic and biotic contributions to dissolved organic carbon (DOC) are required to constrain microbial habitability in continental subsurface fluids. Here we investigate a large (101–283 mg C/L) DOC pool in an ancient (>1Ga), high temperature (45–55 °C), low biomass (102−104 cells/mL), and deep (3.2 km) brine from an uranium-enriched South African gold mine. Excitation-emission matrices (EEMs), negative electrospray ionization (–ESI) 21 tesla Fourier-transform ion cyclotron resonance mass spectrometry (FT-ICR MS), and amino acid analyses suggest the brine DOC is primarily radiolytically oxidized kerogen-rich shales or reefs, methane and ethane, with trace amounts of C3–C6 hydrocarbons and organic sulfides. δ2H and δ13C of C1–C3 hydrocarbons are consistent with abiotic origins. These findings suggest water-rock processes control redox and C cycling, helping support a meagre, slow biosphere over geologic time. A radiolytic-driven, habitable brine may signal similar settings are good targets in the search for life beyond Earth. A deep, ancient, and uranium-rich brine in South Africa reveals evidence of radiolytically oxidized kerogen and C1–C3 hydrocarbons with abiotic isotopic signatures that support a low biomass microbial community over time. [ABSTRACT FROM AUTHOR]

Introduction: HIV controllers have low viral loads (VL) without antiretroviral treatment (ART). We evaluated viraemic control in a community‐randomized trial conducted in Zambia and South Africa that evaluated the impact of a combination prevention intervention on HIV incidence (HPTN 071 [PopART]; 2013–2018). Methods: VL and antiretroviral (ARV) drug testing were performed using plasma samples collected 2 years after enrolment for 4072 participants who were HIV positive at the start of the study intervention. ARV drug use was assessed using a qualitative laboratory assay that detects 22 ARV drugs in five drug classes. Participants were classified as non‐controllers if they had a VL ≥2000 copies/ml with no ARV drugs detected at this visit. Additional VL and ARV drug testing was performed at a second annual study visit to confirm controller status. Participants were classified as controllers if they had VLs <2000 with no ARV drugs detected at both visits. Non‐controllers who had ARV drugs detected at either visit were excluded from the analysis to minimize potential confounders associated with ARV drug access and uptake. Results: The final cohort included 126 viraemic controllers and 766 non‐controllers who had no ARV drugs detected. The prevalence of controllers among the 4072 persons assessed was 3.1% (95% confidence interval [CI]: 2.6%, 3.6%). This should be considered a minimum estimate, since high rates of ARV drug use in the parent study limited the ability to identify controllers. Among the 892 participants in the final cohort, controller status was associated with biological sex (female > male, p = 0.027). There was no significant association between controller status and age, study country or herpes simplex virus type 2 (HSV‐2) status at study enrolment. Conclusions: To our knowledge, this report presents the first large‐scale, population‐level study evaluating the prevalence of viraemic control and associated factors in Africa. A key advantage of this study was that a biomedical assessment was used to assess ARV drug use (vs. self‐reported data). This study identified a large cohort of HIV controllers and non‐controllers not taking ARV drugs, providing a unique repository of longitudinal samples for additional research. This cohort may be useful for further studies investigating the mechanisms of virologic control. [ABSTRACT FROM AUTHOR]

Background: Tuberculosis (TB) prevalence remains persistently high in many settings, with new or expanded interventions required to achieve substantial reductions. The HIV Prevention Trials Network (HPTN) 071 (PopART) community-randomised trial randomised 14 communities to receive the "PopART" intervention during 2014 to 2017 (7 arm A and 7 arm B communities) and 7 communities to receive standard-of-care (arm C). The intervention was delivered door-to-door by community HIV care providers (CHiPs) and included universal HIV testing, facilitated linkage to HIV care at government health clinics, and systematic TB symptom screening. The Tuberculosis Reduction through Expanded Anti-retroviral Treatment and Screening (TREATS) study aimed to measure the impact of delivering the PopART intervention on TB outcomes, in communities with high HIV and TB prevalence. Methods and findings: The study population of the HPTN 071 (PopART) trial included individuals aged ≥15 years living in 21 urban and peri-urban communities in Zambia and South Africa, with a total population of approximately 1 million and an adult HIV prevalence of around 15% at the time of the trial. Two sputum samples for TB testing were provided to CHiPs by individuals who reported ≥1 TB suggestive symptom (a cough for ≥2 weeks, unintentional weight loss ≥1.5 kg in the last month, or current night sweats) or that a household member was currently on TB treatment. Antiretroviral therapy (ART) was offered universally at clinics in arm A and according to local guidelines in arms B and C. The TREATS study was conducted in the same 21 communities as the HPTN 071 (PopART) trial between 2017 and 2022, and TB prevalence was a co-primary endpoint of the TREATS study. The primary comparison was between the PopART intervention (arms A and B combined) and the standard-of-care (arm C). During 2019 to 2021, a TB prevalence survey was conducted among randomly selected individuals aged ≥15 years (approximately 1,750 per community in arms A and B, approximately 3,500 in arm C). Participants were screened on TB symptoms and chest X-ray, with diagnostic testing using Xpert-Ultra followed by culture for individuals who screened positive. Sputum eligibility was determined by the presence of a cough for ≥2 weeks, or ≥2 of 5 "TB suggestive" symptoms (cough, weight loss for ≥4 weeks, night sweats, chest pain, and fever for ≥2 weeks), or chest X-ray CAD4TBv5 score ≥50, or no available X-ray results. TB prevalence was compared between trial arms using standard methods for cluster-randomised trials, with adjustment for age, sex, and HIV status, and multiple imputation was used for missing data on prevalent TB. Among 83,092 individuals who were eligible for the survey, 49,556 (59.6%) participated, 8,083 (16.3%) screened positive, 90.8% (7,336/8,083) provided 2 sputum samples for Xpert-Ultra testing, and 308 (4.2%) required culture confirmation. Overall, estimated TB prevalence was 0.92% (457/49,556). The geometric means of 7 community-level prevalence estimates were 0.91%, 0.70%, and 0.69% in arms A, B, and C, respectively, with no evidence of a difference comparing arms A and B combined with arm C (adjusted prevalence ratio 1.14, 95% confidence interval, CI [0.67, 1.95], p = 0.60). TB prevalence was higher among people living with HIV than HIV–negative individuals, with an age-sex-community adjusted odds ratio of 2.29 [95% CI 1.54, 3.41] in Zambian communities and 1.61 [95% CI 1.13, 2.30] in South African communities. The primary limitations are that the study was powered to detect only large reductions in TB prevalence in the intervention arm compared with standard-of-care, and the between-community variation in TB prevalence was larger than anticipated. Conclusions: There was no evidence that the PopART intervention reduced TB prevalence. Systematic screening for TB that is based on symptom screening alone may not be sufficient to achieve a large reduction in TB prevalence over a period of several years. Including chest X-ray screening alongside TB symptom screening could substantially increase the sensitivity of systematic screening for TB. Trial registration: The TREATS study was registered with ClinicalTrials.gov Identifier: NCT03739736 on November 14, 2018. The HPTN 071 (PopART) trial was registered at ClinicalTrials.gov under number NCT01900977 on July 17, 2013. In a population based cohort study, Eveline Klinkenberg and colleagues examine the impact of the PopART intervention on TB prevalence in Zambia and South Africa. Author summary: Why was this study done?: Tuberculosis (TB) prevalence remains persistently high in many settings, with new or expanded interventions required to achieve substantial reductions. The HIV Prevention Trials Network (HPTN) 071 Population Effects of Antiretroviral Therapy to Reduce HIV Transmission (PopART) community-randomised trial, conducted in 21 Zambian and South African communities (2013 to 2018), provided an opportunity to test whether the PopART intervention—universal testing and universal treatment for HIV combined with universal symptom screening for TB—could reduce TB prevalence. The Tuberculosis Reduction through Expanded Anti-retroviral Treatment and Screening (TREATS) study measured the impact of the PopART intervention on TB prevalence, comparing 14 communities that received the PopART intervention during 2014 to 2017 with 7 communities that received standard-of-care. What did the researchers do and find?: We conducted a TB prevalence survey during 2019 to 2021, among around 50,000 randomly selected individuals aged ≥15 years in the 21 urban and peri-urban communities that were included in the HPTN 071 (PopART) trial. Overall, estimated TB prevalence was 0.92% (457/49,556). There was no evidence of a difference in TB prevalence between the PopART intervention and standard-of-care communities, with an adjusted prevalence ratio of 1.14, 95% confidence interval (CI) [0.67, 1.95]. TB prevalence was around 2 times higher among HIV–positive than HIV–negative individuals, adjusted for age, sex, and community, and several times higher among men than women. What do these findings mean?: This study found no evidence that the PopART intervention reduced TB prevalence, compared with standard-of-care. Systematic screening for TB that is based on symptom screening alone may not be sufficient to achieve a large reduction in TB prevalence over a period of a few years. Including chest X-ray screening alongside TB symptom screening could substantially increase the sensitivity of systematic screening for TB, and several years of delivering such a strategy might be able to achieve a considerable reduction in TB prevalence. [ABSTRACT FROM AUTHOR]

This article discusses the effect of the integration of the Digital Versatile Disc (DVD) as an ICT-variant on the academic performance of full-time geography teacher students enrolled for a Bachelor of Education (B. Ed.) degree at a rural university in a developing country. Action research (which includes both quantitative and qualitative studies), done over three years, attempted to determine if the integration of DVD technology can effectively support the teaching and learning of geography teacher students in a learner-centred learning environment, despite a 55% decrease in contact time, as well as a change of normal contact sessions (lectures) to that of a seminar format. It also explains how the DVD was compiled to suit this DVD method, the DVD method itself and how to employ it effectively in conjunction with seminars. Students' perceptions about this method were continuously considered and changes were made steered by their need and feedback. Results indicate that this learner-centred DVD method was well received and applied by students and that it did not jeopardise their academic performance. (Contains 3 tables and 5 figures.)

This article discusses the results when integrating digital versatile disc (DVD) technology in full-time second-year geography for BEd degree students at a university in South Africa, a developing country. It proposes a framework for the integration of the DVD in geography teaching and learning, steered by students' needs, feedback and observations by the lecturer. The proposed framework recommends clear guidelines on how to integrate the DVD, as well as the interactions between the role players/resources. It also explains how the DVD was compiled, what was included and how it was effectively applied in conjunction with seminars, as an alternative to traditional lectures. An action research design was utilized and both qualitative and quantitative data were collected. (Contains 5 figures and 3 tables.)

Literature relating to personality and entrepreneurship has focused primarily on personality characteristics of traditional entrepreneurs. The focus of this study was on personality characteristics and temperaments of potential Information and Communication Technology (ICT) entrepreneurs. The main objective of the study was to evaluate the efficacy of personality characteristics as identifiers of potential ICT entrepreneurship. The personality characteristics of the participants were measured on the Keirsey Temperament Sorter, a proven research instrument. Two entrepreneurial tests were used to determine entrepreneurial ability. The temperament of the individuals was ascertained and compared to their entrepreneurial ability. The population sample used for this study was comprised of third year and honours information systems students from the University of Cape Town and current ICT entrepreneurs. A positive relationship between the rational and idealist temperaments and potential ICT entrepreneurs was found. No significant relationship between specific personality types and potential entrepreneurial ability were evident in the study. A positive connection was noticed between potential ICT entrepreneurs and being male. Unfortunately the number of female respondents was insufficient to lead to a conclusive result. (Contains 7 figures and 1 table.)

In this study, we developed and validated a questionnaire to assess teachers' perceptions of their actual and preferred school-level environment, investigated whether teachers involved with Outcomes-Based Education (OBE) perceive the school-level environment differently from those who are not, and investigated factors in the school-level environment (such as resources and staff freedom) linked with a school's likelihood of successfully implementing OBE. The study involved modifying and validating an existing questionnaire to make it suitable for assessing the school-level environment in South Africa, as well as adding to the School-Level Environment Survey (SLEQ) the scales of Familiarity with OBE and Parental Involvement. Analysis of data collected from 403 teachers provides evidence for the validity and reliability of the new SLEQ-SA. MANOVA for repeated measures revealed a statistically significant (p less than 0.01) difference between teacher perceptions of their actual school environment and the one that they would prefer for all seven SLEQ-SA dimensions. When MANOVA was used to examine whether teachers involved in OBE perceive their school-level environments differently from those who are not, statistically significant differences emerged for two of the seven school-level environment scales, with teachers involved with OBE perceiving significantly more Familiarity with OBE and Work Pressure. The constraints faced by teachers are wide ranging and include a number of factors such as a lack of material resources and large class sizes. The results provide valuable information to policy-makers, principals and researchers that potentially could help to guide the implementation of OBE.

This paper aims to develop a theoretical and practical framework for lifelong learning which will contribute to bridging the development divide, thus facilitating the implementation of the MDGs on both a global and personal level. We see this happening through the direct personal and professional involvement of development professionals (that is, educators, NGO employees, government workers, researchers, students, and so on) in the application of lifelong learning to achieve a cascade-effect of learning and development throughout all levels of the development community. We propose the utilisation of a matrix of interconnected links, facilitating multilateral communication and interaction. This matrix would allow all the levels from the macro- (interstate community groups, institutions, and other collectives) to the micro- (personal and interpersonal) levels to interact constructively. Such a diverse network of interaction would create a more informed and robust response and implementation strategy towards achieving the objectives set out in the MDGs. This process is envisaged to create an organic nexus of knowledge that would harmonise the implementation strategies between all levels of intervention. We propose the use of the Holistic Personal Relevance Model (HPRM) to refer to this framework that contributes to the fomenting of a multi-level, universal awareness of the goals, plans, obstacles, and possible solutions towards achieving the MDGs. As an example of the HPRM, this article utilised in particular the case of MDG 6, relating to halting and reducing HIV/AIDS and other major diseases. (Contains 11 notes.)

Many South African children live in poverty and food insecurity; therefore, malnutrition within the context of childhood cancer should be examined. Parents/caregivers completed the Poverty-Assessment Tool (divided into poverty risk groups) and the Household Hunger Scale questionnaire in five pediatric oncology units. Height, weight, and mid-upper arm circumference assessments classified malnutrition. Regression analysis evaluated the association of poverty and food insecurity with nutritional status, abandonment of treatment, and one-year overall survival (OS). Nearly a third (27.8%) of 320 patients had a high poverty risk, associated significantly with stunting (p = 0.009), food insecurity (p < 0.001) and residential province (p < 0.001) (multinomial regression). Stunting was independently and significantly associated with one-year OS on univariate analysis. The hunger scale was significant predictor of OS, as patients living with hunger at home had an increased odds ratio for treatment abandonment (OR 4.5; 95% CI 1.0; 19.4; p = 0.045) and hazard for death (HR 3.2; 95% CI 1.02, 9.9; p = 0.046) compared to those with food security. Evaluating sociodemographic factors such as poverty and food insecurity at diagnosis is essential among South African children to identify at-risk children and implement adequate nutritional support during cancer treatment. [ABSTRACT FROM AUTHOR]

Introduction: Universal HIV testing and treatment aims to identify all people living with HIV and offer them treatment, decreasing the number of individuals with unsuppressed HIV and thus reducing HIV transmission. Longitudinal follow‐up of individuals with and without HIV in a cluster‐randomized trial of communities allowed for the examination of community‐ and individual‐level measures of HIV risk and HIV incidence. Methods: HPTN 071 (PopART) was a three‐arm cluster‐randomized trial conducted between 2013 and 2018 that evaluated the use of two combination HIV prevention strategies implemented at the community level to reduce HIV incidence compared to the standard of care. The trial, conducted in 21 communities in Zambia and South Africa, measured HIV incidence over 36 months in a population cohort of ∼2000 randomly selected adults per community aged 18–44. Multilevel models were used to assess the association between HIV incidence and community‐ and individual‐level socio‐demographic and behavioural risk factors, as well as prevalence of detectable virus (PDV) defined as the estimated proportion of the community with unsuppressed viral load. Results: Overall HIV incidence was 1.49/100 person‐years. Communities with less financial wealth and communities with more individuals reporting having sex partners outside of the community or two or more sexual partners had higher HIV incidence. PDV at 2 years of study was 6.8% and was strongly associated with HIV incidence: for every 50% relative reduction in community PDV, there was a 49% (95% confidence interval [CI]: 37%–58%, p < 0.001) relative decrease in HIV incidence. At the individual level; socio‐economic status, AUDIT score, medical male circumcision and certain sexual behaviours were associated with HIV risk. Conclusions: Using data from the PopART randomized trial, we found several associations of HIV incidence with community‐level measures reflecting the sexual behaviour and socio‐economic make‐up of each community. We also found a strong association between community PDV and HIV incidence supporting the use of PDV as a tool for monitoring progress in controlling the epidemic. Lastly, we found significant individual‐level factors of HIV risk that are generally consistent with previous HIV epidemiological research. These results have the potential to identify high high‐incidence communities, inform structural‐level interventions, and optimize individual‐level interventions for HIV prevention. Clinical Trial Number: ClinicalTrials.gov number, NCT01900977, HPTN 071 [PopArt] [ABSTRACT FROM AUTHOR]

Surgical control has prognostic value in neuroblastoma (NB). Advanced NB is common at diagnosis in South Africa. We investigated the pre-surgery factors that influenced decisions to perform surgical resections. We included 204 patients with high-risk NB from a national retrospective study, who completed induction chemotherapy between 2000 and 2016. The median age was 32.4 months (IQR 15.1 − 53.5 months). Primary tumor resection was achieved in 76.9% of patients between 0-18 months of age, 51.8% between 18-60 months and 51.7% older than 60 months (p < 0.001). Only 43.2% of patients with distant metastatic disease had surgery done (p < 0.001). LDH was >750 U/L in 46.8% and ferritin >120 g/dL in 53.1% of those who had surgery (p = 0.005). The majority (80.4%), who had achieved post-induction metastatic complete remission (mCR), were operated, while 28.7% without mCR had surgery (p < 0.001). The long-term overall survival in patients with mCR and primary tumor resection was 36.5% compared to those with mCR without primary tumor resection (25.4%) and without mCR (≤3.0%)(p < 0.001). Age (p < 0.001), stage (p < 0.001), mCR (p < 0.001) and treatment setting (p < 0.001) were of prognostic significance. The tumor site and MYCN-amplification did not significantly predict resection rates. Post-induction mCR and stage were associated with surgical resection and five-year OS (p < 0.001) on multivariate analysis. Patients with high-risk NB who achieved mCR and had primary tumor resections are curable in limited resourced settings. Stage and post-induction mCR were significant variables that led to surgery. These variables should be included as indications in the management of metastatic NB in resource limited settings. High-risk neuroblastoma that achieved post-induction chemotherapy metastatic remission and have undergone resection, is curable, even in limited resource settings. Achieving metastatic complete remission was the only factor that significantly predicated if surgery was done. The age at diagnosis, stage and hospitals with expertise in neuroblastoma surgery were of prognostic significance in South Africa. If a patient with high-risk neuroblastoma achieves metastatic complete remission in a resource limited setting, it should be an indication for resection of the primary tumor. [ABSTRACT FROM AUTHOR]

Mites of the genus Paralycus (Oribatida: Pediculochelidae) are minute, asexual, paedomorphic oribatids that have been largely overlooked by major biodiversity surveys. Here, we review this genus and describe three new species based on adult females: Paralycus persephone sp. n. and Paralycus daeira sp. n. from deep soil in Colorado, USA and Paralycus pricei sp. n. from South Africa. We provide the first complete ontogenetic series in the family using P. daeira sp. n. as a model, clarify the species boundaries in several species, and compile an annotated checklist and key to species of Paralycus of the World. Our work suggests that the pediculochelid biodiversity is underappreciated as these mites may be common in subterranean habitats/deep soil. Further discoveries of the Paralycus diversity in these habitats are anticipated. [ABSTRACT FROM AUTHOR]

In addition to integrated reporting, which was arguably first introduced by the third King Report on Governance for South Africa (King Ⅲ), King Ⅲ also formally introduced the combined assurance model as a further governance innovation, aimed at enhancing the quality of organisational reporting. Although the combined assurance model is primarily an internal enterprise risk management innovation, designed to incorporate, integrate and optimise all assurance services and functions, it simultaneously enhances the credibility of organisational reporting. Taken as a whole, the combined assurance model enables an effective control environment, supports the integrity of information used for internal decision-making by management, the governing body and its committees; while supporting the integrity of the organisation's external reports. Organisations adopting King Ⅳ, including state-owned enterprises (SOEs), are expected to explain how the provisions of the combined assurance model have been implemented. Explaining conformance, introduces an element of innovation into organisational reporting as envisaged by King Ⅳ, by providing stakeholders with assurance about the veracity of the disclosures contained in the internal and external reports of organisations. This exploratory paper analyses the extent to which South African SOEs have conformed to seven key combined assurance indicators. The disclosures contained in the publicly available annual/integrated reports of South African SOEs, listed in Schedule 2 of the Public Finance Management Act (PFMA), were thematically analysed to fulfil the objective of the study. We found that although the combined assurance related disclosures suggest high levels of adoption by some SOEs, the majority have not provided sufficient information to explain how they have applied combined assurance, if at all. Although their reports appear to provide internal management with some level of assurance about the extent to which risks have been managed, these reports may not necessarily provide external users with confidence that all material risks have been effectively mitigated, within the organisation's risk appetite. This paper discuses implications for policy and practice and concludes by providing avenues for further research. [ABSTRACT FROM AUTHOR]

Objectives: Between the 1980s and 2000s, an epidemic of silicosis was identified in migrant black gold miners, many from neighbouring countries, who had worked in the South African gold mines. This study uses the newly available employment database of a large gold mining company to demonstrate how a sustained rise in employment duration in a new cohort of black migrant workers resulted from changes in recruitment policy, and it examines the implications for current surveillance and redress. Methods: Contract data of 300,774 workers from the employment database of a multi-mine gold mining company were analysed for 1973–2018. Piecewise linear regression was applied to determine trends in cumulative employment, including South African versus cross-border miners. The proportions with cumulative employment of at least 10, 15, or 20 years, typical thresholds for chronic silicosis, were also calculated. Results: Five calendar phases were identified between 1973 and 2018. During the second phase, 1985–2013, mean cumulative duration of employment rose fivefold, from 4 to 20 years. Cumulative employment continued to rise, although more slowly, before peaking in 2014 at 23.5 years and falling thereafter to 20.1 years in 2018. Over most of the 1973–2018 period, miners from neighbouring countries had greater cumulative employment than South African miners. Overall, the proportion of miners exiting with at least 15 years of cumulative employment rose from 5% in 1988 to 75% in 2018. This report identifies a number of fundamental changes in labour recruitment policy in the gold mining industry in the 1970s which provide an explanation for the subsequent rise in cumulative exposure and associated silicosis risk. Conclusions: These new data support the hypothesis of a silicosis epidemic driven by increasing cumulative silica dust exposure in a new cohort of circular migrant workers from the 1970s. They inform current programmes to improve surveillance of this neglected population for silicosis and related disease and to provide medical examinations and compensation to a large number of former gold mines. The analysis highlights the lack of information on cumulative employment and silicosis risk among migrant miners in previous decades. The findings have global relevance to the plight of such migrant workers in hazardous occupations. [ABSTRACT FROM AUTHOR]

Background: Thrombotic thrombocytopenic purpura (TTP), a serious thrombotic microangiopathy (TMA), is prevalent in the South African HIV‐infected population. The exact pathogenesis of HIV‐associated TTP (HIV‐TTP) is however still unclear with diagnostic and therapeutic inconsistancies. Methods: A systematic review of the published literature regarding HIV‐TTP was performed. Results: HIV‐TTP is still associated with significant morbidity and mortality in Africa despite the availability of anti‐retroviral therpy (ART). Diagnosis of HIV‐TTP requires the presence of a micro‐angiopathic haemolytic anaemia with significant red blood cell schistocytes and thrombocytopenia in the absence of another TMA but background activation of the coagulation system and inflammation in HIV infected people can result in diagnostic anbiguity. Plasma therapy in the form of infusion or exchange is successful but expensive, associated with side‐effects and not widely available. Adjuvant immunosuppression therapy may of benefit in patients with HIV‐TTP and ART must always be optimised. Endothelial dysfunction caused by chronic inflammation and complement activation most likely contributes to the development of HIV‐TTP. Conclusion: The role of adjuvant immunomodulating therpy, the therapeutic targets and pathogenic contribution from endothelial dysfunction in HIV‐TTP requires further investigation. [ABSTRACT FROM AUTHOR]

Purpose: The formal adoption of internal auditing within the South African public sector was made compulsory by the Public Finance Management Act, No. 1 of 1999. Despite internal auditing's primary role of adding value and assisting organisations to accomplish pre-defined strategic objectives, the increasing frequency of service delivery protests in South Africa, suggests that mandatory internal auditing may not have contributed to improving public sector performance and enhancing service delivery, as envisaged. This paper aims to identify the factors preventing internal audits from effectively contributing to improved public sector performance and service delivery. Design/methodology/approach: The study adopted a sequential mixed-methods research approach. Firstly, a survey instrument was used to collect empirical data from survey respondents at South African national government departments. Secondly, semi-structured interviews and focus group discussions were held with a purposively selected sample of participants to explore the observations from the first phase. The observations from the first two phases were validated through an analysis of pertinent documents and records. Findings: Despite all departments adopting internal auditing, management's expectations of internal auditing and the services provided by the internal audit function diverged. The results suggest that the emergence of a compliance approach to organisational governance together with poor performance management skills has impaired internal auditing's ability to effectively contribute to strategic and performance management. Research limitations/implications: Despite its South African orientation, as internal auditing is a global association and given that service delivery protests continue to occur in several countries around the world, increases the study's international relevance. Moreover, the mandate of internal auditing requires it to add value to an organisation irrespective of its geographical location. Originality/value: The study contributes to the existing body of knowledge on internal auditing, particularly its adoption and implementation in the South African public sector. In addition to identifying the factors inhibiting effective internal auditing, the study advances a suggested framework for the future of internal auditing. [ABSTRACT FROM AUTHOR]

Background Antiretroviral therapy (ART) reduces human immunodeficiency virus (HIV) transmission risk. The primary aim of this study was to evaluate ART uptake in a trial in Zambia and South Africa that implemented a community-wide universal testing and treatment package to reduce HIV incidence. Methods Study communities were randomized to 3 arms: A, combination-prevention intervention with universal ART; B, combination-prevention intervention with ART according to local guidelines; and C, standard of care. Samples were collected from people with HIV (PWH) during a survey visit conducted 2 years after study implementation: these samples were tested for 22 antiretroviral (ARV) drugs. Antiretroviral therapy uptake was defined as detection of ≥1 ARV drug. Resistance was evaluated in 612 randomly selected viremic participants. A 2-stage, cluster-based approach was used to assess the impact of the study intervention on ART uptake. Results Antiretroviral drugs were detected in 4419 of 6207 (71%) samples (Arm A, 73%; Arm B, 70%; Arm C, 60%); 4140 (94%) of samples with ARV drugs had viral loads <400 copies/mL. Drug resistance was observed in 237 of 612 (39%) viremic participants (95 of 102 [93%] with ARV drugs; 142 of 510 [28%] without drugs). Antiretroviral therapy uptake was associated with older age, female sex, enrollment year, seroconverter status, and self-reported ART (all P <.001). The adjusted risk ratio for ART uptake was similar for Arm A versus C (1.21; 95% confidence interval [CI],.94–1.54; P =.12) and Arm B versus C (1.14; 95% CI,.89–1.46; P =.26). Conclusions At the 2-year survey, 71% of PWH were on ART and 94% of those participants were virally suppressed. Universal testing and treatment was not significantly associated with increased ART uptake in this cohort. [ABSTRACT FROM AUTHOR]

Until recently, research examining the application of Rational Emotive Behavior Therapy (REBT) in sports settings was virtually absent in South Africa. Despite the growing evidence of REBT's potential as a psychological intervention in Western nations, its use within the multicultural and sports-fervent context of South Africa remains unexplored. Moreover, limited research has addressed the impact of REBT on rugby players, with only a few case studies being reported. The current experiment employs a cluster randomized trial (CRT) to compare the effects of a 7-week preferential REBT program with a 7-week Mindfulness-Acceptance-Commitment (MAC) program on irrational beliefs, competitive anxiety and subjective performance, among adolescent South African rugby players. We also include a wait-list control group who received neither REBT nor MAC. Results indicate that athletes receiving REBT reported greater improvements in irrational beliefs, anxiety, and subjective performance, while that athletes receiving MAC also reported some improvements in anxiety. This study highlights the potential of REBT as a valuable psychological intervention in the context of South African adolescent rugby players. • Sport REBT research has never been done in South African sports. • Cluster Randomised Trial (CRT) compares a 7-week REBT with a 7-week MAC on rugby players. • REBT group showed a significant reduction in irrational beliefs. [ABSTRACT FROM AUTHOR]

Environmental water requirements (EWRs) are set for South Africa's estuaries to ensure that they are maintained in a state that is both achievable and commensurate with their level of conservation and economic importance. However, these EWRs are typically determined on the basis of models and scenario analyses that require extrapolation beyond existing data and experience, especially if climate change is considered. In the case of the Berg Estuary, South Africa, available data on changes in freshwater flow and water quality span a period of at least five decades (1970s--present) during which significant reduction in flows has been observed. Monitoring data also cover an extreme 3-year drought, from 2015-2017, which provided a unique opportunity to study the effects of severe freshwater starvation (zero-flow for an extended period) on this large, permanently open system. Our analyses show that mean annual runoff (MAR) under present-day conditions has been reduced to around 50% of that under reference (natural) conditions and that reduction in runoff during the low-flow season (summer) has been more severe (80-86% reduction) than for the high-flow season (39-42% reduction). The salinity gradient now extends much further upstream than under reference conditions. Hypersaline conditions along with a reverse salinity gradient were recorded in the estuary for the first time ever during the drought of 2015/17. Levels of dissolved inorganic nitrogen (NOx) reaching the estuary from the catchment have increased dramatically (6-7 fold) over the past five decades, dissolved reactive phosphate (PO4) slightly less so (2-3 fold), but ammonia (NH4) hardly at all. Increases in nutrient input from the catchment in the high-flow season are also much more dramatic than in the low-flow season. The estuary is no longer compliant with gazetted EWRs and requires urgent interventions to restore the quantity and quality of freshwater it receives. [ABSTRACT FROM AUTHOR]

Introduction: Universal HIV testing and treatment (UTT) has individual and public health benefits. HPTN 071 (PopART), a community‐randomized trial in Zambia and South Africa, demonstrated that UTT decreased HIV incidence. This endpoint was assessed in a cohort of >48,000 randomly selected adults in the study communities. We evaluated the impact of UTT on HIV drug resistance in this cohort and compared other resistance‐related outcomes in participants with recent versus non‐recent HIV infection. Methods: Two years after the start of HPTN 071 (2016–2017), 6259 participants were HIV positive and 1902 were viremic (viral load >400 copies/ml). HIV genotyping and antiretroviral (ARV) drug testing were performed for viremic participants in three groups: seroconverters (infected <1 year), non‐seroconverters (infected >1 year, random subset) and participants with unknown duration of infection (random subset). A two‐stage cluster‐based approach was used to assess the impact of the study intervention on drug resistance. Treatment failure was defined as being viremic with ARV drugs detected. Participants were classified as ARV naïve based on self‐report and ARV drug testing. Results: Genotyping results were obtained for 758 participants (143 seroconverters; 534 non‐seroconverters; and 81 unknown duration of infection). The estimated prevalence of resistance in the study communities was 37% for all viremic persons and 11% for all HIV‐positive persons. There was no association between UTT and drug resistance. Resistance was detected in 14.0% of seroconverters and 40.8% of non‐seroconverters (non‐nucleoside reverse transcriptase inhibitor resistance: 14.0% and 39.9%; nucleoside/nucleotide reverse transcriptase inhibitor resistance: 0.7% and 15.5%; protease inhibitor resistance: 0% and 1.9%; multi‐class resistance: 0.7% and 16.1%, respectively). ARV drugs were detected in 2/139 (1.4%) of seroconverters and 94/534 (17.6%) of non‐seroconverters tested. These participants were classified as failing ART; 88 (93.6%) of the non‐seroconverters failing ART had resistance. Mutations used for surveillance of transmitted drug resistance were detected in 10.5% of seroconverters and 15.1% of non‐seroconverters who were ARV naive. Conclusions: UTT was not associated with an increase in drug resistance in this cohort. Higher rates of drug resistance and multi‐class resistance were observed in non‐seroconverters compared to seroconverters. [ABSTRACT FROM AUTHOR]

Background: Real-world evaluation of the safety profile of vaccines after licensure is crucial to accurately characterise safety beyond clinical trials, support continued use, and thereby improve public confidence. The Sisonke study aimed to assess the safety and effectiveness of the Janssen Ad26.COV2.S vaccine among healthcare workers (HCWs) in South Africa. Here, we present the safety data. Methods and findings: In this open-label phase 3b implementation study among all eligible HCWs in South Africa registered in the national Electronic Vaccination Data System (EVDS), we monitored adverse events (AEs) at vaccination sites through self-reporting triggered by text messages after vaccination, healthcare provider reports, and active case finding. The frequency and incidence rate of non-serious and serious AEs were evaluated from the day of first vaccination (17 February 2021) until 28 days after the final vaccination in the study (15 June 2021). COVID-19 breakthrough infections, hospitalisations, and deaths were ascertained via linkage of the electronic vaccination register with existing national databases. Among 477,234 participants, 10,279 AEs were reported, of which 138 (1.3%) were serious AEs (SAEs) or AEs of special interest. Women reported more AEs than men (2.3% versus 1.6%). AE reports decreased with increasing age (3.2% for age 18–30 years, 2.1% for age 31–45 years, 1.8% for age 46–55 years, and 1.5% for age > 55 years). Participants with previous COVID-19 infection reported slightly more AEs (2.6% versus 2.1%). The most common reactogenicity events were headache (n = 4,923) and body aches (n = 4,483), followed by injection site pain (n = 2,767) and fever (n = 2,731), and most occurred within 48 hours of vaccination. Two cases of thrombosis with thrombocytopenia syndrome and 4 cases of Guillain-Barré Syndrome were reported post-vaccination. Most SAEs and AEs of special interest (n = 138) occurred at lower than the expected population rates. Vascular (n = 37; 39.1/100,000 person-years) and nervous system disorders (n = 31; 31.7/100,000 person-years), immune system disorders (n = 24; 24.3/100,000 person-years), and infections and infestations (n = 19; 20.1/100,000 person-years) were the most common reported SAE categories. A limitation of the study was the single-arm design, with limited routinely collected morbidity comparator data in the study setting. Conclusions: We observed similar patterns of AEs as in phase 3 trials. AEs were mostly expected reactogenicity signs and symptoms. Furthermore, most SAEs occurred below expected rates. The single-dose Ad26.COV2.S vaccine demonstrated an acceptable safety profile, supporting the continued use of this vaccine in this setting. Trial registration: ClinicalTrials.gov NCT04838795; Pan African Clinical Trials Registry PACTR202102855526180. Saimbarashe Takuva, Azwi Takalani, and colleagues investigate the frequency and incidence of adverse events reported after receipt of a single dose of the Ad26.COV2.S COVID-19 vaccine among health care workers in South Africa. Author summary: Why was this study done?: While the safety of the Ad26.COV2.S vaccine was established in phase 3 clinical trials, continuous evaluation of safety in expanded populations is crucial. The Sisonke phase 3b implementation study enrolled almost half a million healthcare workers, providing an opportunity to further evaluate the safety of the single-dose Ad26.COV2.S vaccine. What did the researchers do and find?: A total of 477,234 healthcare workers across all South African provinces received the Ad26.COV2.S vaccine between 17 February 2021 and 17 May 2021. Through self-reports and active case finding, adverse events, serious adverse events, and adverse events of special interest were identified. Overall occurrence of adverse events was low. The majority of adverse events reported were common reactogenicity signs and symptoms. Most serious adverse events and adverse events of special interest, including vascular events, immune system disorders, and deaths, occurred at lower than the expected population rates. What do these findings mean?: The single-dose Ad26.COV2.S vaccine had an acceptable safety profile. This supports continued use of this vaccine in large rollout programmes. [ABSTRACT FROM AUTHOR]

Background Rift Valley fever virus (RVFV) is an arbovirus that causes epizootics and epidemics among livestock population and humans. Our surveillance system has revealed multiple emergences and re-emergences of RVFV in West Africa over the last decade. Methods The Sentinel Syndromic Surveillance Network in Senegal (4S) has been implemented since 2011. Samples from human suspected arbovirus infection in 4S sentinel sites were sent to Institut Pasteur de Dakar (IPD), where arbovirus diagnosis by enzyme-linked immunosorbent assay (ELISA), real-time reverse transcription polymerase chain reaction (RT-PCR), and virus isolation was performed. Overall, IPD has received a total of 1149 samples from arboviral suspected patients through the 4S network from January to December 2020. These samples were screened for 7 arboviruses including RVFV. Whole-genome sequencing of positive RVFV samples by RT-PCR was performed using the Illumina Miseq platform followed by genome assembly. Phylogenetic analyses were performed using MEGA X. Results Out of the 1149 arbovirus suspected cases, 4 RVFV-positive samples were detected with RT-PCR while 5 RVFV-positive samples were detected by ELISA. Complete genome sequences were obtained for 3 strains among the 4 positive samples by RT-PCR. Phylogenetic analyses indicated an emergence of a virus first described in South Africa during a major outbreak. Conclusions This strong surveillance system allowed the detection of an RVFV outbreak in Senegal in 2020. The obtained genomes clustered with strains from South Africa belonging to lineage H. This calls for implementation of a strong surveillance system for wild animals, humans, and livestock simultaneously in all African countries. [ABSTRACT FROM AUTHOR]

Warfarin remains the most widely prescribed oral anticoagulant in sub‐Saharan Africa. However, because of its narrow therapeutic index, dosing can be challenging. We have therefore (a) evaluated and compared the performance of 21 machine‐learning techniques in predicting stable warfarin dose in sub‐Saharan Black‐African patients and (b) externally validated a previously developed Warfarin Anticoagulation in Patients in Sub‐Saharan Africa (War‐PATH) clinical dose–initiation algorithm. The development cohort included 364 patients recruited from eight outpatient clinics and hospital departments in Uganda and South Africa (June 2018–July 2019). Validation was conducted using an external validation cohort (270 patients recruited from August 2019 to March 2020 in 12 outpatient clinics and hospital departments). Based on the mean absolute error (MAE; mean of absolute differences between the actual and predicted doses), random forest regression (12.07 mg/week; 95% confidence interval [CI], 10.39–13.76) was the best performing machine‐learning technique in the external validation cohort, whereas the worst performing technique was model trees (17.59 mg/week; 95% CI, 15.75–19.43). By comparison, the simple, commonly used regression technique (ordinary least squares) performed similarly to more complex supervised machine‐learning techniques and achieved an MAE of 13.01 mg/week (95% CI, 11.45–14.58). In summary, we have demonstrated that simpler regression techniques perform similarly to more complex supervised machine‐learning techniques. We have also externally validated our previously developed clinical dose–initiation algorithm, which is being prospectively tested for clinical utility. [ABSTRACT FROM AUTHOR]

Community engagement is crucial for controlling disease outbreak and mitigating natural and industrial disasters. The COVID-19 pandemic has reconfirmed the need to elevate community engagement to build equity, trust and sustained action in future health promotion preparedness strategies. Using the health promotion strategy of strengthening community action enhances the opportunity for better outcomes. There is, therefore, a need to improve our understanding of community engagement practices during crises, scale-up good community engagement initiatives, and improve and sustain people-centered approaches to emergency responses. This paper presents five case studies from the United States, Singapore, Sierra Leone, Kenya and South Africa that demonstrate the potential strengths that can be nurtured to build resilience in local communities to help mitigate the impact of disasters and emergencies. The case studies highlight the importance of co-developing relevant education and communication strategies, amplifying the role of community leaders, empowering community members to achieve shared goals, assessing and adapting to changing contexts, pre-planning and readiness for future emergencies and acknowledgement of historic context. [ABSTRACT FROM AUTHOR]

South African children with Hodgkin lymphoma (HL) and human immunodeficiency virus (HIV) have low 5-year overall survival (OS) rates. In this retrospective multicenter study, 271 South African pediatric patients with HL were studied to determine OS and prognostic factors in those with HIV and HL. Univariate risk factor analysis was performed to analyze prognostic factors. The 29 HIV-infected patients were younger (p =.021), more likely to present with wasting (0.0573), stunting (0.0332), and Stage IV disease (p =.000) than HIV-uninfected patients. The 5- and 10-year OS of HIV-infected patients of 49% and 45% versus 84% and 79%, respectively for HIV-uninfected patients (p =.0001) appeared to be associated with hypoalbuminemia (<20 g/dL) and CD4 percentage of <15%. Causes of death in the HIV-infected group included disease progression (6/14), infection (4/14), unknown (3/14), and second malignancy (1/14). HIV-infected pediatric patients with HL experience increased mortality due to post-therapy opportunistic and nosocomial infections. [ABSTRACT FROM AUTHOR]