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Although HIV infection can be managed with antiretroviral drugs, there is no cure and therapy has to be taken for life. Recent successes in animal models with HIV-specific broadly neutralising antibodies (bNAbs) have led to long-term virological remission and even possible cures in some cases. This has resulted in substantial investment in human studies to explore bNAbs as a curative intervention for HIV infection. Emerging data are encouraging, but suggest that combinations of bNAbs with other immunomodulatory agents may be needed to induce and sustain long-term viral control. As a result, a number of clinical trials are currently underway exploring these combinations. If successful, the impact for the millions of people living with HIV could be substantial. Here, we review the background to the use of bNAbs in the search for an HIV cure and how different adjunctive agents might be used together to enhance their efficacy.

This comparative psychobiographical study provides an in-depth exploration of meaning in the lives of two extraordinary individuals, Helen Suzman and Beyers Naudé. A comparison of the construction of meaning, as an important aspect of wellness within the holistic wellness model, is given for these South African anti-apartheid activists. Suzman (1917–2009) dedicated her career to opposing apartheid policy as a parliamentary politician. Naudé (1915–2004) was a renowned public figure dedicated to social justice in his role as a theologian. The holistic wellness model views the Neo-Adlerian life task of spirituality as crucial to ascribing meaning to life events, acknowledging multiple potential sources of meaning. The differences and similarities pertaining to the domains of meaning-making of these two subjects are explored. The subjects, who differed regarding biographical variables, were found to share a common sense of purpose within the same socio-political milieu. The study findings confirm that commitment to diverse sources of meaning and generativity are central to meaningfulness. This comparative psychobiographical study contributes to the eugraphic exploration of the meaning-making processes of these exemplary individuals.

Mindfulness-based techniques have been used in the medical context to reduce patient distress. This study aimed to explore the acceptability of colouring in as a mindfulness-based activity for chemotherapy patients. In a randomised controlled trial investigating the effectiveness of colouring in as a stress-reducing activity, 18 participants in the intervention group completed self-report questionnaires, an adapted distress scale, a 30-min colouring-in activity, a post-intervention distress scale as well as an acceptability questionnaire. This article reports on the high level of acceptability of this mindfulness-based activity. Over three-quarters of participants experienced it as positive, half recorded lower distress scores after colouring in, 83.0% reported a subjective reduction in distress and 89% confirmed that they would use the activity again. The high level of acceptability found in this study warrants further consideration of colouring in as a cost-effective mindfulness strategy.

Background: Anxiety disorders are the most prevalent class of lifetime mental disorders according to South African research. However, little is known about the prevalence of factors that might complicate treatment among adults in a psychiatric outpatient setting. Aim: To explore the psychiatric comorbidities and psychosocial stressors among a population of adults treated for anxiety disorders at the outpatient unit of a tertiary psychiatric facility in Bloemfontein. Methods: In this retrospective cross-sectional study, clinical files of all mental healthcare users receiving treatment were reviewed to identify those with a current or previous diagnosis of one or more of the following anxiety disorders: generalised anxiety disorder (GAD), panic disorder, social anxiety disorder (SAD) and agoraphobia. Results: Of the 650 available records, 103 (15.8%) included at least one anxiety disorder. Of those, 65.1% had GAD, 34.0% had panic disorder and 29.1% had SAD. Agoraphobia was diagnosed in 14.6% of patients almost exclusively as comorbid with panic disorder. Additional psychiatric disorders were present for 98.1% of patients and 36.9% had multiple anxiety disorders. The patients had a history of relational problems (64.1%), educational and occupational stressors (55.3%), abuse and neglect (28.2%), other problems related to the social environment (24.3%) and self-harm (23.3%). Conclusion: Clinical practice should take the high rates of comorbidity into account and the importance of integrated substance-related interventions in mental healthcare settings is clear. Diagnostic practices regarding agoraphobia without panic, and the comorbidity of anxiety and personality disorders should receive further attention. Clinicians should be aware of the potential impact of the frequently reported psychosocial stressors.

Background: Information regarding lifetime exposure to potentially traumatic events is critical in the management of various psychiatric disorders. Recent South African research suggests high levels of trauma exposure in the general population, however, the prevalence and type of potentially traumatic events among tertiary psychiatric patients are unknown. Objective: The study aimed to explore and describe the extent and nature of reported potentially traumatic events and associated variables in adult patients referred for psychological services at the Free State Psychiatric Complex (FSPC), Bloemfontein. Methods: In this cross-sectional study, demographic information, diagnostic morbidity and co-morbidity, and presence and type of reported trauma exposure reported by patients during the initial assessment were obtained from files of adult patients seen during a one-year period (2010) at the out-patient unit and the in-patient affective ward at the FSPC. Data were captured on data record forms by the researchers and analysed by means of descriptive statistics, univariate analysis and logistic regression (SAS version 9.1). Results: Of the 192 adults (71.9% White and 67.2% female) referred for psychological services,75.5% were diagnosed with mood disorders, 17.2% with anxiety disorders, 22.4% with substance-related disorders and 20.9% with cluster B personality disorders or traits. A total of 145 (75.5%) reported past trauma exposure. The most frequently reported types of trauma exposure were traumatic death/injury of a loved one (37.0%), physical assault (24.5%), witnessed/threatened violence (19.3%), and sexual assault (17.7%). Women were more likely to have been exposed to trauma than men (OR 4.02, 95% CI 1.87–8.62), in particular to traumatic death of a loved one (OR 3.13), physical assault (OR 4.08), or sexual assault (OR 5.43). Conclusions: The findings of this study contribute to current data regarding the prevalence of exposure to trauma and its possible association with mental illness. The importance of comprehensive trauma exposure screening in routine psychiatric interviewing practices is highlighted.

Introduction: Neonatal sepsis (NS) is a global public health concern, particularly affecting developing countries. Challenges in diagnostics, more specifically, culture and antimicrobial susceptibility testing hinder effective management of the disease. Objective: This study aims to evaluate the burden, describe the management, and assess the evolution of NS in a hospitalized pediatric population in Haiti. Methods: A retrospective cohort study from January 2013 to December 2018 at La Paix University Hospital was conducted. All-cause hospitalizations and deaths were extracted from hospital’s Neonatology Unit records and were used to derive data regarding hospitalization and death among patients under 28 days with NS. Clinical and laboratory data were extracted from the patients’ medical records. Results: Out of 2,424 post-childbirth hospitalizations, 1,590 involved sepsis. The percentage of hospitalization due to NS was approximately 69% and the percentage of deaths, 65%. The mean age of patients with NS was 3.75 days (0 - 22 days), with a slight male predominance (55%, p < 0.001). Peaks were observed from May to August (p = 0.02). Early NS cases (NS in patients aged less than 7 days) were most prevalent (86%, p < 0.001). Specimen culture and antimicrobial susceptibility testing was less frequent (7%) than complete blood count usage (65%). Findings regarding blood count included leukopenia (3%), thrombocytopenia (30%). A positive CRP and acute renal failure were noted in 76% and 21.7% of cases, respectively. The average hospital stay was 7.3 days. With regards to treatment, 73% of patients received a 2-drug antimicrobial therapy (ampicillin-gentamycin) and 22% received a 3-drug antimicrobial therapy (ampicillin-gentamycin-cefotaxime). Of all newborns hospitalized for NS, 49% received empirical antibiotic therapy within 3 hours of admission. Conclusions: This research highlights NS as a public health emergency in Haiti. The study advocates for improved access to culture and antibiotic susceptibility testing and emphasizes the impact of timely antibiotic administration. The findings of this study serve as a baseline for informing policymakers and medical practitioners dedicated to improving existing conditions of neonates in Haiti. Suggested targeted interventions include preventive measures during prenatal visits, strengthening laboratory capacities, improving infection prevention and control measures, and developing antimicrobial stewardship programs.