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The purpose of this study was to compare two different methods to teach educators about HIV/AIDS. Sixty educators were selected from eight schools in KwaZulu-Natal Province, South Africa, to undergo HIV/AIDS training using an interactive CD-ROM intervention. Another sixty educators from other schools were selected to undergo a two-day Life Skills Training Programme provided by the Department of Education. The outcomes both before and after the interventions were measured by surveying the educators' knowledge and attitudes related to HIV/AIDS, as well as their self-efficacy with respect to dealing with HIV/AIDS in the classroom setting. Both interventions resulted in significant changes in knowledge and attitudes as well as in the self-efficacy with respect to ability to teach about HIV/AIDS and to deal with classroom situations involving HIV and blood. The Life Skills Training Programme proved superior in enhancing basic knowledge about HIV, and the CD-ROM was superior in teaching about HIV transmission risks.

Introduction: An estimated 38 million people are living with human immunodeficiency virus (HIV) worldwide. Pharmacists are well positioned to provide care to patients with HIV, but gaps in HIV education among pharmacists exist. Recognizing the need to educate and prepare future pharmacists, a 2-credit advanced HIV elective course was created for Doctor of Pharmacy students at Washington State University College of Pharmacy and Pharmaceutical Sciences in the United States, and Masters of Clinical Pharmacy students from University of Western Cape School of Pharmacy in South Africa. Methods: Course topics included diagnosis and treatment of HIV in children and adults, management of common comorbidities, pre-exposure prophylaxis, pharmacogenetic applications, and antiretroviral drug-drug interactions. Course effectiveness was evaluated using student examination results. Student perceptions were evaluated using pre- and post-course self-assessments involving abilities, confidence, and attitudes toward caring for people living with HIV. Results: Student pharmacists demonstrated competency in HIV knowledge, demonstrated skills in application to clinical-based scenarios, and reported significantly improved confidence and abilities as well as positive changes in attitudes toward people with HIV. Conclusion: This course contributed to student learning across different student cohorts in an institutional program in the United States including successful execution of distance learning and clinical application for students at a program in South Africa. [ABSTRACT FROM AUTHOR]

Background: One hundred and twenty educators from KwaZulu-Natal, South Africa, underwent HIV/AIDS training. The educators were surveyed about their attitudes toward people with HIV. Methods: The educators completed self-administered survey questionnaires both before and after 2 interventions. Measures included demographic characteristics, teachers' knowledge about HIV/AIDS, self-efficacy in handling HIV/AIDS situations, and attitudes (stigma and otherwise) toward HIV-related issues. The first intervention was a CD-ROM and the second intervention involved educators receiving a 2-day workshop on HIV transmission, risk factors, and actions that educators should know and undertake. The first step entailed testing the stigma instrument for its internal consistency and developing and testing potential subscales from the instrument. The second step entailed testing for the statistical associations between stigma (as measured by the stigma instrument and its subscales) and various demographic and HIV knowledge-related variables. Results: The overall stigma scale had a Cronbach [alpha] coefficient of 0.66. Educators in the workshop generally had lower baseline levels of stigma than those in the CD-ROM intervention. Following both interventions, the stigma levels of both groups of educators were significantly reduced. Improvements in the general knowledge about HIV as a disease and in the specific knowledge about HIV transmission risks were both statistically significantly associated with reductions in stigma attitudes, having controlled for educators' baseline stigma levels and demographic profiles. Conclusions: The levels of teachers' stigma attitudes were statistically significantly lower after both types of HIV/AIDS training and were also statistically significantly associated with improvements in HIV knowledge. (Contains 4 tables.)

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity (Ptrend =.020) and 1.00, 0.64, 047, and 0.64 for high body fat (Ptrend =.012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries. [ABSTRACT FROM AUTHOR]

Here we describe a new species for the genus Oregoniplana from the coast of China, representing the third species for the genus and the first record of this genus for Asia. The other species are known from Oregon, USA, and from South Africa. Specimens of the South African species, Oregoniplana pantherina , were recently rediscovered, forming the second record for the species, which provided the basis for a necessary re-description. Molecular data (18S rDNA and 28S rDNA) obtained for the new Chinese species facilitated determination of the position of the genus Oregoniplana in the phylogenetic tree of the marine triclads. We report molecular data also for species previously discovered in China, viz. Miroplana shenzhensis and Pentacoelum sinensis , thus enabling us to determine for the first time the phylogenetic position of the genus Miroplana. These new molecular data revealed that Pentacoleum sinensis occupies an unexpected position in the phylogenetic tree. Laboratory cultures of the new Chinese species provided information on food preferences and reproduction. Oregoniplana pantherina exhibits a peculiar kind of locomotion and an unusual resting position in which the animal has three points of contact on either side. [ABSTRACT FROM AUTHOR]

Introduction: there is a lack of longitudinal studies investigating daily tobacco use and problem drinking in Africa. The aim of this study was to explore the prevalence of daily tobacco use and problem drinking and to determine the factors associated with daily tobacco use and problem drinking among urban dwellers in a longitudinal study in South Africa. Methods: electronic interview data were collected from 2213 adults (mean age 45.7 years, SD=15.1; range 20-97) at time 1 (baseline assessment) and Time 2 (12 months follow-up assessment) from one urban centre in South Africa. Results: daily tobacco use only, was at time 1 24.0% and at time 2 23.4%, a decrease of 0.5%. Problem drinking only was at time 1 19.6% and at time 2 21.1%, an increase of 1.5%. Concurrent daily tobacco use and problem drinking increased from time 1 9.5% to 10.3% at time 2, an increase of 0.8%. In longitudinal regression analyses, being male and being born in current city were significantly associated with all three substance use indicators (daily tobacco use; problem drinking; and concurrent daily tobacco use and problem drinking). In addition, older age, not currently married, lower education, underweight and higher levels of perceived stress were associated with daily tobacco use and younger age was associated with problem drinking. Conclusion: high prevalence of daily tobacco use and problem drinking were found among urban dwellers and several sociodemographic (being male, being born in the city, not married and lower education) and health variables (being underweight and perceived stress) were identified which can guide substance use intervention programmes for this population. [ABSTRACT FROM AUTHOR]

The major structural component of a blood clot is a meshwork of fibrin fibers. It has long been thought that the internal structure of fibrin fibers is homogeneous; that is, the protein density and the bond density between protofibrils are uniform and do not depend on fiber diameter. We performed experiments to investigate the internal structure of fibrin fibers. We formed fibrin fibers with fluorescently labeled fibrinogen and determined the light intensity of a fiber, I, as a function of fiber diameter, D. The intensity and, thus, the total number of fibrin molecules in a cross-section scaled as D1.4. This means that the protein density (fibrin per cross-sectional area), ρp, is not homogeneous but instead strongly decreases with fiber diameter as D-0.6. Thinner fibers are denser than thicker fibers. We also determined Young’s modulus, Y, as a function of fiber diameter. Y decreased strongly with increasing D; Y scaled as D-1.5. This implies that the bond density, ρb, also scales as D-1.5. Thinner fibers are stiffer than thicker fibers. Our data suggest that fibrin fibers have a dense, well-connected core and a sparse, loosely connected periphery. In contrast, electrospun fibrinogen fibers, used as a control, have a homogeneous cross-section. [ABSTRACT FROM AUTHOR]

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Depression and other health problems are common co-morbidities among persons living with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS). The aim of this study was to investigate depression, health status, and substance use in relation to HIV-infected and uninfected individuals in South Africa. Using a cross-sectional case-control design, we compared depression, physical health, mental health, problem alcohol use, and tobacco use in a sample of HIV-infected (N= 143) and HIV-uninfected (N= 199) respondents who had known their HIV status for two months. We found that depression was higher, and physical health and mental health were lower in HIV-positive than HIV-negative individuals. Poor physical health also moderated the effect of HIV infection on depression; HIV-positive individuals were significantly more depressed than HIV-negative controls, but only when general physical health was also poor. We did not find an association between alcohol or tobacco use and HIV status. These results suggest the importance of incorporating the management of psychological health in the treatment of HIV. [ABSTRACT FROM AUTHOR]

We compare four different risk-taking propensity measures on their ability to describe and to predict actual risky behavior in the domain of health. The risk-taking propensity measures we compare are: (1) a general measure of risk- taking propensity derived from a one-item survey question (Dohmen et al., 2011), (2) a risk aversion index calculated from a set of incentivized monetary gambles (Holt & Laury, 2002), (3) a measure of risk taking derived from an incentive compatible behavioral task--the Balloon Analog Risk Task (Lejuez et al., 2002), and (4) a composite score of risk-taking likelihood in the health domain from the Domain-Specific Risk Taking (DOSPERT) scale (Weber et al., 2002). Study participants are 351 clients of health centers around Witbank, South Africa. Our findings suggest that the one-item general measure is the best predictor of risky health behavior in our population, predicting two out of four behaviors at the 5% level and the remaining two behaviors at the 10% level. The DOSPERT score in the health domain performs well, predicting one out of four behaviors at the 1% significance level and two out of four behaviors at the 10% level, but only if the DOSPERT instrument contains a hypothetical risk-taking item that is similar to the actual risky behavior being predicted. Incentivized monetary gambles and the behavioral task were unrelated to actual health behaviors; they were unable to predict any of the risky health behaviors at the 10% level. We provide evidence that this is not because the participants had trouble understanding the monetary trade-off questions or performed poorly in the behavioral task. We conclude by urging researchers to further test the usefulness of the one-item general measure, both in explaining health related risk-taking behavior and in other contexts. [ABSTRACT FROM AUTHOR]

Unlike large firms with management teams, small businesses are usually run by one key person, the owner-entrepreneur, who bears almost all of the risks and makes most of the decisions related to the business. Because the owner-entrepreneur also embodies most of the firm-specific knowledge capital, health of the owner-entrepreneur is an important factor in the production process. Following a cohort of respondents in townships around Durban, South Africa, over a three-year period, we examined the relationship between an individual's physical health and the decision to start a business. Our results suggest respondents who were recent business entrants were in better health than respondents who did not start new businesses. Moreover, respondents without a business at the beginning of the study who later opened businesses during the study interval were significantly more likely to have better baseline health than those respondents who never started a new business. Hence, good health among entrepreneurs seems to be an important prerequisite to small business entry. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare two different methods to teach educators about HIV/AIDS. Sixty educators were selected from eight schools in KwaZulu-Natal Province, South Africa, to undergo HIV/AIDS training using an interactive CD-ROM intervention. Another sixty educators from other schools were selected to undergo a two-day Life Skills Training Programme provided by the Department of Education. The outcomes both before and after the interventions were measured by surveying the educators' knowledge and attitudes related to HIV/AIDS, as well as their self-efficacy with respect to dealing with HIV/AIDS in the classroom setting. Both interventions resulted in significant changes in knowledge and attitudes as well as in the selfefficacy with respect to ability to teach about HIV/AIDS and to deal with classroom situations involving HIV and blood. The Life Skills Training Programme proved superior in enhancing basic knowledge about HIV, and the CD-ROM was superior in teaching about HIV transmission risks. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate family planning needs, knowledge of HIV transmission and HIV disclosure in a cohort sample that had undergone PMTCT in a resource poor setting. Five public clinics implementing PMTCT from Qaukeni Local Service Area, O.R. Tambo District in the Eastern Cape. The sample at postnatal care consisted of 758 women with known HIV status. From 116 HIV positive women 76.3% and from 642 HIV negative women 85.2% got counseling on safe sex during pregnancy but only 65.8% and 62.3% of the women respectively practiced safe sex during pregnancy, which did not differ by HIV status. Postnatally, almost all women received counseling on family planning, yet use of contraceptives and condoms were low. Among HIV positive women PMTCT knowledge and younger age of the mother were associated with pregnancy desire, and among HIV negative women HIV disclosure to the partner, younger age of the mother and having a lower number of children were associated with pregnancy desire. High pregnancy desires (yet lower than for HIV negative women); low contraceptive and condom use were found among HIV positive women. HIV prevention and family planning must acknowledge the reproductive desires of HIV positive women and men. [ABSTRACT FROM AUTHOR]

A total of 120 teachers from KwaZulu-Natal, South Africa, underwent HIV/AIDS training. As part of the study, the teachers were surveyed, before and after the training, about their perceptions of HIV prevalences among pupils, other teachers, and community members, and about their perceptions of their own HIV status. Before the training, the teachers estimated average HIV prevalences among pupils, other teachers, and other community members to be 36%, 48%, and 61%, respectively. One-third of the teachers believed that they had a 50% or greater chance of currently being infected with HIV. Male teachers and teachers with a university degree gave lower HIV prevalence estimates for other people but not for themselves. Frequency of condom use was positively related to teachers’ HIV prevalence estimates for other people. Teachers’ estimates of HIV prevalence and perceived risk of own HIV infection increased significantly after the HIV/AIDS training. [ABSTRACT FROM AUTHOR]

Small businesses contribute almost 50 percent of total employment and 30 percent of gross domestic product in South Africa, but the impact of poor health and AIDS on these businesses is poorly documented. Using three waves of longitudinal data from predominantly African neighborhoods in peri-urban Durban, South Africa, this project investigates the connections between the health of the owner of a micro- and small enterprise (MSE) and the MSE's growth, survival, or exit. The results show that poor baseline health and declines in health over time are both significantly associated with subsequent business closure. [ABSTRACT FROM AUTHOR]

Global eutrophication and climate warming exacerbate production of cyanotoxins such as microcystins (MCs), presenting risks to human and animal health. Africa is a continent suffering from severe environmental crises, including MC intoxication, but with very limited understanding of the occurrence and extent of MCs. By analysing 90 publications from 1989 to 2019, we found that in various water bodies where MCs have been detected so far, the concentrations were 1.4–2803 times higher than the WHO provisional guideline for human lifetime exposure via drinking water (1 µg/L) in 12 of 15 African countries where data were available. MCs were relatively high in the Republic of South Africa (averaged 2803 μg/L) and Southern Africa as a whole (702 μg/L) when compared to other regions. Values were higher in reservoirs (958 μg/L) and lakes (159 μg/L) than in other water types, and much higher in temperate (1381 μg/L) than in arid (161 μg/L) and tropical (4 μg/L) zones. Highly significant positive relationships were found between MCs and planktonic chlorophyll a. Further assessment revealed high ecological risk for 14 of the 56 water bodies, with half used as human drinking water sources. Recognizing the extremely high MCs and exposure risk in Africa, we recommend routine monitoring and risk assessment of MCs be prioritized to ensure safe water use and sustainability in this region. [Display omitted] • A database was established for microcystins (MCs) in African inland waters. • In 12 studied countries, MC concentrations exceeded by 1.4–2803 times the guideline. • MC occurrence is most hazardous in reservoirs and lakes, and in the temperate zone. • Waterbodies providing drinking water in Africa have a high risk of MC-exposure. • MCs were significantly positively related to planktonic chlorophyll a concentration. [ABSTRACT FROM AUTHOR]

Background: WHO has targeted that medicines to prevent recurrent cardiovascular disease be available in 80% of communities and used by 50% of eligible individuals by 2025. We have previously reported that use of these medicines is very low, but now aim to assess how such low use relates to their lack of availability or poor affordability.Methods: We analysed information about availability and costs of cardiovascular disease medicines (aspirin, β blockers, angiotensin-converting enzyme inhibitors, and statins) in pharmacies gathered from 596 communities in 18 countries participating in the Prospective Urban Rural Epidemiology (PURE) study. Medicines were considered available if present at the pharmacy when surveyed, and affordable if their combined cost was less than 20% of household capacity-to-pay. We compared results from high-income, upper middle-income, lower middle-income, and low-income countries. Data from India were presented separately given its large, generic pharmaceutical industry.Findings: Communities were recruited between Jan 1, 2003, and Dec 31, 2013. All four cardiovascular disease medicines were available in 61 (95%) of 64 urban and 27 (90%) of 30 rural communities in high-income countries, 53 (80%) of 66 urban and 43 (73%) of 59 rural communities in upper middle-income countries, 69 (62%) of 111 urban and 42 (37%) of 114 rural communities in lower middle-income countries, eight (25%) of 32 urban and one (3%) of 30 rural communities in low-income countries (excluding India), and 34 (89%) of 38 urban and 42 (81%) of 52 rural communities in India. The four cardiovascular disease medicines were potentially unaffordable for 0·14% of households in high-income countries (14 of 9934 households), 25% of upper middle-income countries (6299 of 24,776), 33% of lower middle-income countries (13,253 of 40,023), 60% of low-income countries (excluding India; 1976 of 3312), and 59% households in India (9939 of 16,874). In low-income and middle-income countries, patients with previous cardiovascular disease were less likely to use all four medicines if fewer than four were available (odds ratio [OR] 0·16, 95% CI 0·04-0·57). In communities in which all four medicines were available, patients were less likely to use medicines if the household potentially could not afford them (0·16, 0·04-0·55).Interpretation: Secondary prevention medicines are unavailable and unaffordable for a large proportion of communities and households in upper middle-income, lower middle-income, and low-income countries, which have very low use of these medicines. Improvements to the availability and affordability of key medicines is likely to enhance their use and help towards achieving WHO's targets of 50% use of key medicines by 2025.Funding: Population Health Research Institute, the Canadian Institutes of Health Research, Heart and Stroke Foundation of Ontario, AstraZeneca (Canada), Sanofi-Aventis (France and Canada), Boehringer Ingelheim (Germany and Canada), Servier, GlaxoSmithKline, Novartis, King Pharma, and national or local organisations in participating countries. [ABSTRACT FROM AUTHOR]