bluuebunny/crossref_metadata_2025 huggingface dataset:
Application and Design of Patient Temperature Acquisition System Based on Wireless Sensor Network
Authors: Ding Huijie
Published: June 2017

The purpose of this study is to achieve large-scale real-time acquisition and monitoring of the patient’s body temperature, for noticing abnormal phenomenon of temperature in time. In the ward, arrange ZigBee wireless temperature monitoring network, realize the ward patients temperature measurement and gathering of temperature related clinical data, achieve the temperature monitoring network through the serial RS232 and PC communication, and PC receives, displays, and processes the data through the serial port. The results showed that the system can also realize the acquisition, transmission and monitoring of a plurality of temperature signals, and send out the alarm in abnormal temperature. As a result, the system can be widely used in clinical measurement, suitable for popularization in large hospital with a large number of patients
An Improved Time Synchronization Algorithm for Wireless Sensor Networks
Authors: Sun Jihong , Shao Huanzheng
Published: June 2017

Wireless sensor network (WSN) has been paid more and more attention to by the international academic and industrial fields. What’s more, it has become a hot research topic with great attention and expectations. There are a lot of technical problems involved in wireless sensor networks, among which, time synchronization technology is one of the supporting technologies in wireless sensor networks. And it is rather essential for the application of wireless sensor network. Two classical time synchronization algorithms are introduced and their advantages and disadvantages are compared. Based on the existing algorithms, an improved time synchronization algorithm is put forward. The improved algorithm was simulated by NS2. The results showed that the proposed algorithm had better time synchronization accuracy and lower network cost than RBS and TPSN algorithm. In summary, the improved time synchronization algorithm has a rather good performance.
Complementary Health Practitioners in the Acute and Critical Care Setting: Nursing Considerations
Authors: Kramlich Debra
Published: June 2017

In response to the rising demand by patients and their families for complementary health approaches, hospitals are increasingly integrating complementary health approaches with their conventional medical practices to create healing environments. Results of the 2010 Complementary and Alternative Medicine Survey of Hospitals indicated that the top 6 inpatient modalities included pet therapy, massage therapy, music or art therapy, guided imagery, relaxation therapy, and Reiki and therapeutic touch. Whether complementary health approaches are provided by complementary health practitioners through hospital-based integrative medicine programs, volunteer practitioners, or bedside nurses, the regulatory, legal, ethical, and safety concerns remain constant. Previous articles in this column of Critical Care Nurse provided an overview of complementary health approaches that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses, as well as important legal, ethical, safety, quality, and financial implications that acute and critical care nurses should consider when integrating complementary health approaches with conventional care. This column provides the acute and critical care nurse with key information about validation of credentials, experience, and competence of nurses and volunteers providing complementary health approaches, as well as about institutional policies and scope of practice.
Effect of pH Test-Strip Characteristics on Accuracy of Readings
Authors: Metheny Norma A. , Gunn Emily M. , Rubbelke Cynthia S. , Quillen Terrilynn Fox , Ezekiel Uthayashanker R. , Meert Kathleen L.
Published: June 2017

BACKGROUND

Little is known about characteristics of colorimetric pH test strips that are most likely to be associated with accurate interpretations in clinical situations.

OBJECTIVES

To compare the accuracy of 4 pH test strips with varying characteristics (ie, multiple vs single colorimetric squares per calibration, and differing calibration units [1.0 vs 0.5]).

METHODS

A convenience sample of 100 upper-level nursing students with normal color vision was recruited to evaluate the accuracy of the test strips. Six buffer solutions (pH range, 3.0 to 6.0) were used during the testing procedure. Each of the 100 participants performed 20 pH tests in random order, providing a total of 2000 readings. The sensitivity and specificity of each test strip was computed. In addition, the degree to which the test strips under- or overestimated the pH values was analyzed using descriptive statistics.

RESULTS

Our criterion for correct readings was an exact match with the pH buffer solution being evaluated. Although none of the test strips evaluated in our study was 100% accurate at all of the measured pH values, those with multiple squares per pH calibration were clearly superior overall to those with a single test square.

CONCLUSIONS

Test strips with multiple squares per calibration were associated with greater overall accuracy than test strips with a single square per calibration. However, because variable degrees of error were observed in all of the test strips, use of a pH meter is recommended when precise readings are crucial.
Nurse-Directed Blood Glucose Management in a Medical Intensive Care Unit
Authors: Compton Friederike , Ahlborn Robert , Weidehoff Torsten
Published: June 2017

BACKGROUND

Insulin-delivery algorithms for achieving glycemic control in the intensive care unit require frequent checks of blood glucose level and thus increase nursing workload. Hypoglycemia is a serious complication associated with intensive insulin therapy.

OBJECTIVES

To evaluate a nurse-directed protocol for blood glucose management that allows individualized insulin delivery within a predefined blood glucose corridor, intended to avoid hypoglycemia while maintaining adequate control of blood glucose level without increasing nursing workload.

METHODS

A nurse-directed protocol for blood glucose management was developed by an interprofessional team, and the protocol’s performance was investigated in 175 patients compared with 384 historical controls.

RESULTS

With the nurse-directed protocol, hypoglycemia incidents declined significantly (31% vs 12%, P < .001), and minimum blood glucose levels increased significantly (80 mg/dL vs 93 mg/dL, P < .001). Mean and maximum blood glucose levels, the proportion of glucose readings within the target range (31% vs 26%, P = .06), and the number of blood glucose checks (59 vs 58, P = .85) remained unchanged with use of the protocol.

CONCLUSION

Implementation of the nurse-directed protocol for blood glucose management did not increase nursing workload but reduced hypoglycemia incidents significantly while maintaining adequate glycemic control.
Heme Oxygenase-1 Modulates Human Respiratory Syncytial Virus Replication and Lung Pathogenesis during Infection
Authors: Espinoza Janyra A. , León Miguel A. , Céspedes Pablo F. , Gómez Roberto S. , Canedo-Marroquín Gisela , Riquelme Sebastían A. , Salazar-Echegarai Francisco J. , Blancou Phillipe , Simon Thomas , Anegon Ignacio , Lay Margarita K. , González Pablo A. , Riedel Claudia A. , Bueno Susan M. , Kalergis Alexis M.
Published: June 2017

Human respiratory syncytial virus (hRSV) is the leading cause of severe lower respiratory tract infections in children. The development of novel prophylactic and therapeutic antiviral drugs against hRSV is imperative to control the burden of disease in the susceptible population. In this study, we examined the effects of inducing the activity of the host enzyme heme oxygenase-1 (HO-1) on hRSV replication and pathogenesis on lung inflammation induced by this virus. Our results show that after hRSV infection, HO-1 induction with metalloporphyrin cobalt protoporphyrin IX significantly reduces the loss of body weight due to hRSV-induced disease. Further, HO-1 induction also decreased viral replication and lung inflammation, as evidenced by a reduced neutrophil infiltration into the airways, with diminished cytokine and chemokine production and reduced T cell function. Concomitantly, upon cobalt protoporphyrin IX treatment, there is a significant upregulation in the production of IFN-α/β mRNAs in the lungs. Furthermore, similar antiviral and protective effects occur by inducing the expression of human HO-1 in MHC class II+ cells in transgenic mice. Finally, in vitro data suggest that HO-1 induction can modulate the susceptibility of cells, especially the airway epithelial cells, to hRSV infection.
Single-Cell RNA Sequencing Reveals Expanded Clones of Islet Antigen-Reactive CD4+ T Cells in Peripheral Blood of Subjects with Type 1 Diabetes
Authors: Cerosaletti Karen , Barahmand-pour-Whitman Fariba , Yang Junbao , DeBerg Hannah A. , Dufort Matthew J. , Murray Sara A. , Israelsson Elisabeth , Speake Cate , Gersuk Vivian H. , Eddy James A. , Reijonen Helena , Greenbaum Carla J. , Kwok William W. , Wambre Erik , Prlic Martin , Gottardo Raphael , Nepom Gerald T. , Linsley Peter S.
Published: June 2017

The significance of islet Ag-reactive T cells found in peripheral blood of type 1 diabetes (T1D) subjects is unclear, partly because similar cells are also found in healthy control (HC) subjects. We hypothesized that key disease-associated cells would show evidence of prior Ag exposure, inferred from expanded TCR clonotypes, and essential phenotypic properties in their transcriptomes. To test this, we developed single-cell RNA sequencing procedures for identifying TCR clonotypes and transcript phenotypes in individual T cells. We applied these procedures to analysis of islet Ag-reactive CD4+ memory T cells from the blood of T1D and HC individuals after activation with pooled immunodominant islet peptides. We found extensive TCR clonotype sharing in Ag-activated cells, especially from individual T1D subjects, consistent with in vivo T cell expansion during disease progression. The expanded clonotype from one T1D subject was detected at repeat visits spanning >15 mo, demonstrating clonotype stability. Notably, we found no clonotype sharing between subjects, indicating a predominance of “private” TCR specificities. Expanded clones from two T1D subjects recognized distinct IGRP peptides, implicating this molecule as a trigger for CD4+ T cell expansion. Although overall transcript profiles of cells from HC and T1D subjects were similar, profiles from the most expanded clones were distinctive. Our findings demonstrate that islet Ag-reactive CD4+ memory T cells with unique Ag specificities and phenotypes are expanded during disease progression and can be detected by single-cell analysis of peripheral blood.
Spectra evolution over on-vine holding of Italia table grapes: prediction of maturity and discrimination for harvest times using a Vis-NIR hyperspectral device
Authors: Piazzolla Francesca , Amodio Maria Luisa , Colelli Giancarlo
Published: June 2017

Measurement of certain grape quality parameters (sugars, acidity, and pH-value) is essential for the determination of the optimum harvest time. Non-destructive analytical techniques, including near infrared (NIR) spectroscopy, can be valid alternatives to traditional analytical methods for the determination of maturity indexes, enabling the possibility of on-field applications. This work aims to study the reliability to monitor spectra changes related with ripening of table grapes and to select optimal wavelengths for the discrimination of bunches from different harvests, in addition to the prediction of total soluble solids, pH, titratable acidity, phenols and antioxidant activity of table grapes. Grapes were harvested four times from the same plants at day 0 (I HT), and after 11 (II HT), 27 (III HT) and 48 (IV HT) days. Spectra were acquired from the images obtained using a spectral scanner Vis-NIR (ver 1.4.; DV Srl, Padova, Italy), with a detector in the region between 400-1000 nm principal component analysis was used to remove outliers followed by spectra pre-treatment. The best prediction model was achieved for soluble solids with the regression coefficient values of 0.91 for calibration and 0.88 for validation followed by titratable acidity (0.71 and 0.78) and antioxidant activity (0.68 and 0.62). In addition an excellent correlation was observed between spectra and days before harvest (R2 of 0.98 for calibration and prediction models) indicating that is possible to relate spectra changes with ripening, leading also to the effective discrimination of the fruits from the different harvest times. The results showed that this technique may be a valid support to select the optimal harvest time also based on the prediction of the maturity related constituents.
Media use and preference related to coronary heart disease of the coloured population of the Cape Peninsula the crisic study
Authors: Steyn M. , Steyn K.
Published: June 2017

As a part of a comprehensive coronary risk factor study among the coloured population of the Cape Peninsula (the CRISIC study), the media use and preference of the population were examined with a view to suggesting appropriate media for conveying health messages. A stratified sample (N = 976) was randomly drawn from the coloured population in the age group 15 to 64 years in the Cape Peninsula. Data were collected by means of a pre-tested questionnaire. Analysis of the data showed that information on the prevention of heart disease was obtained in greater measure from the mass media than from interpersonal communication. As far as media preference is concerned, television was considered the most effective medium for conveying information to the community, followed by instruction given to school children. Greater use of health educators to convey health messages, as well as a multi-media approach, is suggested for a successful intervention programme.
’n kritiese beskouing van die rol en funksies van die gemeenskapsgesondheids verpleegkundige in groot stedelike plaaslike owerheidsdienste in die Republiek van Suid-Afrika
Authors: Dreyer Johanna M.
Published: June 2017

The aim o f this study was to determine and describe the role and functions o f the community health nurse in the health services o f local authorities o f the larger cities within the framework o f legislation regarding health and the health service structure o f the Republic o f South Africa. A questionnaire was used to gather data in connection with the present role and functions o f the community health nurse who is responsible fo r direct client I patient care in the local authority areas o f Greater Cape Town, Port Elizabeth, Durban, Pretoria, Johannesburg and Bloemfontein. The information gained from the questionnaires was followed up by personal observations o f the services tendered in Greater Cape Town, Durban and Johannesburg, after it had been computed. The study indicates that the community health nurse in the urban, local authority health services o f the Republic makes a very important contribution to the delivery o f services within the provisions o f the Health Act, no. 63 of 1977. The analysis o f the computed data and personal observations showed that the community health nurse in the large cities must carry out a certain percentage o f the administrative, educational, preventive, promotive, curative and rehabilitative activities in the services.
The role of the nursing staff in promoting the development of preterm infants through their contribution to motherinfant interaction
Authors: Grieve Kate
Published: June 2017

Preterm birth constitutes a potential risk factor for infant development. There is evidence that parental sensitivity and responsivity can compensate for biological risk. Since the birth of a preterm infant often constitutes a crisis for parents, they may be impaired in their ability to relate appropriately to their infants. The nursing staff can play a vital role in enhancing the interaction between parents (in particular mothers) and their preterm infants, thereby indirectly promoting optimal infant development. This paper describes the psychological tasks faced by mothers of preterm infants, parents’ experiences of preterm birth and suggestions as to what the nursing staff can do to facilitate healthy relationships between parents and their preterm infants, thereby preventing possible pathological development.
'n Woord vooraf
Authors: Pont A. D.
Published: June 2017

No abstract available.
Prof. Dr Engelbrecht - 'n Vriend van die Jeug
Authors: Le Roux L. M.
Published: June 2017

No abstract available.
Menswaardigheid en Menslike Regte na aanleiding van die Skrif
Authors: Wolmarans H. P.
Published: June 2017

No abstract available.
Boekbespreking
Authors: Dryer P. S.
Published: June 2017

No abstract available.
Teosofie
Authors: Dryer P. S.
Published: June 2017

No abstract available.
Rudolf Bultmann: Nie saam met die kerk en soos die kerk nie.
Authors: Koekemoer P. J. T.
Published: June 2017

Lesing gehou by die opening van die Teologiese Fakulteit Afd. A, Universiteit Pretoria aan die 'begin van die akademiese Jaar 1965 op 16 Februarie 1965.
Charting African Prosperity Gospel economies
Authors: Heuser Andreas
Published: June 2017

This article maps the vital debate on Prosperity Gospel in Africa and its relevance for socioeconomic change. Prosperity Gospel centres mainly on speech acts surrounding faith, wealth and victory, combined with ritual enactments around secondary evidences of divine blessings. Claiming this-worldly success and material well-being as signs of grace it has captured public spheres and has created African religio-scapes of prosperity. The survey on the socioeconomics of African prosperity-oriented Pentecostalism firstly traces the historic genealogy of Prosperity Gospel as transposable message. It appears as a generic formula in paradigmatic reinventions of Pentecostalism in post-second and/or cold war America and in its globalisation in postcolonial Africa. The double resignification of Pentecostal theology - a rereading of ‘mammon’ alongside a new ethic of being in the world - relates to the question of socioeconomic agency. Academic discourse connects Prosperity Gospel social capital with interpretations of its ritual texture thriving around rituals of tithings and offerings. Prosperity Gospel economies are profiled as forms of sacral consumption or sacrificial economy, or else as Pentecostal kleptocracy. Contrarily Prosperity Gospel is portrayed as a variant and porter of African social change. The contextualisation of Prosperity Gospel highlights diverse social agency in different milieus. Rural and peri-urban theologies of survival differ from urban progressive and metropolitan business management Prosperity Gospel. The findings defy generalised views on Prosperity Gospel socioeconomics. African Prosperity Gospel indicates a transformative potential in immediate social relationships, whereas claims of impacting structural parameters of society remain, with a few exceptions, part of Pentecostal imagination.
Man, nature and conservation
Authors: Hey D.
Published: June 2017

I am sure that it is common cause at a gathering such as this that we live in a country of remarkable scenic beauty. Consider for example, our extensive beaches of golden sands, spectacular rocky headlands, rugged mountain chains, vast Karoo's, desert landscapes, rolling grasslands, acacia studded savannas and the unique bushveld where we are gathered today.
Keeping the records straight: The literary afterlife of three Boer generals
Authors: Gray Stephen R.
Published: June 2017

The intention of this article is to highlight some overlooked or lesser-known facets of the remarkable biographies of three Boer generals (Cronjé, Viljoen and De Wet). They achieved fame, particularly in the English-language media and publishing circles, immediately after the Second Anglo-Boer War. Whilst their reputations in the written literature are unassailable and of recurring interest, perhaps some over-mythologising has been responsible for occasional distortions which render their superb life stories less satisfying. The surprising and unexpected aftermath of such details in the subsequent records is also noted.
Beyond African nationalism: Isaiah Shembe’s hymns and African literature
Authors: Sithole Nkosinathi
Published: June 2017

This article deals with Isaiah Shembe’s hymns and proposes that they should be read asliterature because, in them, Shembe employs a number of literary features. He also usesfeatures of oral literature and uses the hymns to reflect on a number of issues that concernedhim and his fellow black people. The hymns that are examined here are more akin to poetrythan hymns in that Shembe uses them to engage with the issues of his time rather than to praiseGod. However, this does not mean that all the hymns should be misconstrued as politicaltexts: They are generally songs of worship for the members to sing when praising God, yetShembe also found in the genre of hymns a powerful medium for voicing his concerns asan African. Whilst other scholars have noted Shembe’s concern with Zulu ethnicity and hiscontribution to Zulu literature, I suggest here a reading of the hymns that goes beyond Zuluethnicity, looking at them as part of African literature since Shembe himself was not justconcerned with the Zulus and their problems, but he was also concerned with the mattersthat concerned Africa as a whole.
Conserving (not preserving) culture: Avoiding the damage to culture of veiled moralism in HIV education
Authors: Price Leigh
Published: June 2017

Language mechanisms in much HIV discourse insist that a Western-based moralism dominates. These mechanisms include: the use of strategic absences of information about the moral grounding of texts; and slippages of meaning, where one word is used to refer to many meanings. A common slippage of meaning is the use of the word ‘polygamy’ to refer to a range of behaviours, thus hiding low HIV risk sexual practices (polyfidelity) under the same umbrella as high risk practices (promiscuity) and advocating their general removal. Another dubious method of achieving a moral position is to take a true premise and use it to advance a false conclusion. For example, the true premise that wife inheritance in its historical form is an HIV risk does not automatically lead to the conclusion that wife inheritance ‘must’ be eradicated. This is only one possible conclusion. Another, more culturally sensitive, conclusion could be that wife inheritance should be embarked upon, as should all sexual relationships, in a context of HIV tests, and safer sexual practice. I argue that moralism (such as ‘wife inheritance is morally wrong’) cloaked as science (the claim that science ‘proves’ the moral position that wife inheritance is wrong) is a threat to traditional culture and discriminates against up-holders of traditional lifestyles. Drawing primarily from my experience of HIV education in a development setting in Southern Africa, I offer a weak (realist) moral relativism as an alternative to, on the one hand, the positivist-based, absolutist morality which threatens to destroy traditional cultures in the name of HIV education and, on the other hand, extreme cultural relativism in which ‘anything goes’. Possibly, HIV educators have not done enough to include some traditional safer sex practices in their professional inventory of acceptable behaviours, such as hlobonga (thigh sex) and polygamy interpreted as polyfidelity. My hope is that by being more respectful of traditional culture, whilst encouraging cultural change where necessary, HIV education will register greater success in achieving safer sexual practice. This article will be particularly useful for writers and researchers tasked with achieving behavioural change and/or tasked with writing educational materials on HIV in the Southern African context.
From the editor
Authors: Bekker Linda-Gail
Published: June 2017

N/A
Infant feeding and HIV
Authors: Goga Ameena Ebrahim
Published: June 2017

Recent studies on antiretroviral prophylaxis during breastfeeding show that maternal HAART (alone or with 1,4 or 24 weeks infant prophylaxis) or infant prophylaxis alone (with limited maternal prophylaxis) for 6, 14 or 24 weeks reduces HIV transmission through breastmilk (postnatal transmission). Maternal postnatal regimens appear to be as efficacious as infant postnatal regimens, although one study shows a trend favouring infant nevirapine over maternal HAART (both used from 1 week to 6 months post-delivery). These new findings necessitate a review of existing PMTCT interventions, and the immediate implementation of regimens that reduce postnatal transmission - where this is feasible – to save children’s lives. In the public sector, whilst stakeholders engage in discussions about which is the best regimen to minimise postnatal transmission SSSUPPORT should be given to all HIV-positive women, as explained below, to improve infant outcomes and reduce postnatal transmission: Screen all women for HIV, Send off CD4 cell counts on all HIV-positive women, Screen all HIV-positive women for AFASS using a standardised tool (e.g. Table 3); Understand the woman’s personal and socio-cultural context; Promote exclusive or predominant breastfeeding if all AFASS criteria are not met; Promote exclusive formula feeding if all AFASS criteria are met; Organise supplies of formula milk and cotrimoxazole; Review mothers and infants in the first 3 days post-delivery, in the first two weeks postnatally and monthly thereafter, and review health and feeding practices, regardless of feeding choice, at every visit; lastly Treat all pregnant women with HAART if they meet national criteria for HAART initiation.
Changing antiretroviral therapy in children
Authors: Levin Leon
Published: June 2017

No abstract
Stigma, human rights, testing and treatment – time for action: Ruben Sher Memorial Lecture, 26 November 2009
Authors: Cameron Edwin
Published: June 2017

None available
Message from the Executive
Authors: Venter Francois
Published: June 2017

N/A
Provincial differences in infant deaths in South Africa – an effect of antiretroviral interventions?
Authors: Boulle A , Thompson M L , Laubscher R , Johnson L F , Sayed R , Brody L L , Draper B , Cotton M F , Abdullah F , Myers J E , Bourne D E
Published: June 2017

Original article
Trans-hiatal oesophagectomy in a AIDS patient
Authors: De Zoysa M I M , Sivaganesh S , Abayadeera A U , Buddakorala K
Published: June 2017

A 49-year-old man was diagnosed as HIV infected, with a CD4 count of 60 cells/µl. He was started on an antiretroviral treatment regimen comprising zidovudine, lamivudine and efavirenz. Following treatment, his CD4 count improved and the viral load was undetectable. He was subsequently found to have a moderately differentiated adenocarcinoma of the lower oesophagus.
Access to antiretroviral treatment in South Africa, 2004 - 2011
Authors: Johnson Leigh Francis
Published: June 2017

Background. South Africa’s National Strategic Plan (NSP) for 2007 - 2011 aimed to achieve new antiretroviral treatment (ART) enrolment numbers equal to 80% of the number of newly eligible individuals in each year, by 2011.

Objectives. To estimate ART coverage in South Africa and assess whether NSP targets have been met.

Methods. ART data were collected from public and private providers of ART. Estimates of HIV incidence rates were obtained from independent demographic projection models. Adult ART data and incidence estimates were entered into a separate model that estimated rates of progression through CD4 stages, and the model was fitted to South African CD4 data and HIV prevalence data.

Results. By the middle of 2011, the number of patients receiving ART in South Africa had increased to 1.79 million (95% CI 1.65 - 1.93 million). Adult ART coverage, at the previous ART eligibility criterion of CD4
A review of the use of blood and blood products in HIV-infected patients
Authors: van den Berg Karen
Published: June 2017

Despite numerous publications on the appropriate use of blood and blood products, few specifically consider the role of transfusion in the management of HIV. This review is a synthesis of conditions encountered in the management of HIV-infected patients where the transfusion of blood or blood products may be indicated. A consistent message emerging from the review is that the principles of transfusion medicine do not differ between HIV-negative and -positive patients. The aim of the review is to provide clinicians with a practical and succinct overview of the haematological abnormalities and clinical circumstances most commonly encountered in the HIV setting, while focusing on the rational and appropriate use of blood and blood products for HIV patients. Important ethical considerations in dealing with both the collection and transfusion blood and blood products in the HIV era have also been addressed.

S Afr J HIV Med 2012;13(2):87-103.
Risk factors for discordant immune response among HIV-infected patients initiating antiretroviral therapy: A retrospective cohort study
Authors: Muzah B P , Takuva S , Maskew M , Delany-Moretlwe S
Published: June 2017

Background. The therapeutic goal of antiretroviral therapy (ART) is sustained immune recovery and viral suppression. However, some patients experience poor CD4 cell count responses despite achieving viral suppression. Such discordant immune responses have been associated with poor clinical outcomes.

Objective. We aimed to determine the prevalence of discordant immune response and explore associated factors in a retrospective cohort of patients attending 2 large public sector clinics, during the 6 months following ART initiation.

Methods. Data were analysed from 810 HIV-infected adults initiated on first-line ART at 2 clinics in Johannesburg, between 1 November 2008 and 31 December 2009. Multivariate logistic regression models were used to estimate adjusted odds ratios (AORs) to determine associations between discordant immune response and clinical and demographic factors.

Results. At ART initiation, 65% (n=592) of participants were female, with a mean age of 38.5 years. Median baseline CD4 cell count was 155 cells/mm3, 70% (n=645) of patients had a haemoglobin level >11 g/dl and 88% (n=803) were initiated on stavudine-lamivudine-efavirenz/nevirapine (D4T-3TC-EFV/NVP). Six months after ART initiation, 24% (n=220) of patients had a discordant immune response and 7% (n=67) a discordant virological response. On multivariate analysis, baseline CD cell count ≥200 cells/mm3 (AOR 3.02; 95% confidence interval (CI) 2.08 - 4.38; p
Is Option B+ the best choice?
Authors: A Coutsoudis , Goga A , Desmond C , Barron P , Black V , Coovadia H
Published: June 2017

This article is reprinted from The Lancet, with permission from Elsevier: Coutsodis A, Goga A, Desmond C, Barron P, Black V, Coovadia H. Is Option B+ the best choice? Lancet 2013;381(9863):269-271. [http://dx/doi.org/10.1016/S0140-6736(12)61807-8]

The success of prevention of mother-to-child transmission (PMTCT) programmes (Options A and B) in middle-income countries, together with clinical trial data on antiretroviral (ARV) treatment as prophylaxis, has emboldened UN agencies to aggressively promote lifelong ARVs for PMTCT (Option B+). Unsubstantiated claims submit that Option B+ is cost-effective at population-level, will protect HIV-negative male partners, improve maternal and infant health, and increase ARV coverage. We provide counterfactual arguments about the ethics, medical safety, programme feasibility and economic benefits of Option B+. Option B+ offers no advantage to PMTCT and there are social hazards associated with privileging pregnant woman for treatment over men and non-pregnant women, especially with the absence of data to suggest that discordant relationships are more frequent among pregnant women or that they contribute disproportionately to the horizontal HIV transmission. The benefits and safety of long-term ARVs – including adherence and resistance – in mothers who do not need treatment for their own health, need to be considered, as well as, crucially, health service costs. The assumption that a decrease in efficiency caused by inappropriate targeting is compensated for by lower recruitment costs, is untested. Lives could be saved instead with appropriately targeted interventions. Countries should make individual decisions based on their HIV epidemiology, resources, priorities and local evidence.

S Afr J HIV Med 2013;14(1):8-10. DOI:10.7196/SAJHIVMED.898
Child privacy rights: A ‘Cinderella’ issue in HIV-prevention research
Authors: Strode Ann Elaine , Slack Catherine
Published: June 2017

Legal debates regarding child participation in HIV research have tended to focus on issues of informed consent. However, much less attention has been given to privacy; accordingly, we classify this as a ‘Cinderella issue’ that has been excluded from ‘the ball’ (academic debate). Here we argue that privacy issues are as important as consent issues in HIV-prevention research. We describe a child’s right to privacy regarding certain health interventions in South African law, and identify four key norms that flow from the law and that could be applied to HIV-prevention research: (i) children cannot have an expectation of privacy regarding research participation if they have not given independent consent to the study; (ii) children may have an expectation of privacy regarding certain components of the study, such as HIV testing, if they consent independently to such services; (iii) children’s rights to privacy in health research are limited by mandatory reporting obligations; (iv) children’s rights to privacy in HIV-prevention research may be justifiably limited by the concept of the best interests of the child. We conclude with guidelines for researchers on how to implement these principles in HIV-related research studies.
Consensus statement: Management of drug-induced liver injury in HIV-positive patients treated for TB
Authors: Jong E , Conradie F , Berhanu R , Black A , John M-A , Meintjes G , Menezes C
Published: June 2017

Drug-induced liver injury (DILI) in HIV/tuberculosis (TB) co-infected patients is a common problem in the South African setting, and re-introduction of anti-TB drugs can be challenging for the healthcare worker. Although international guidelines on the re-introduction of TB treatment are available, the definition of DILI is not uniform, management of antiretroviral therapy (ART) in HIV co-infection is not mentioned, and the guidance on management is not uniform and lacks a practical approach. In this consensus statement, we summarise important aspects of DILI and provide practical guidance for healthcare workers for different patient groups and healthcare settings on the re-introduction of anti-TB drugs and ART in HIV/TB co-infected individuals presenting with DILI.
HIV risk behaviour among public primary healthcare patients with tuberculosis in South Africa
Authors: Peltzer Karl
Published: June 2017

Objective. To identify factors associated with HIV in tuberculosis (TB) patients in a public primary healthcare (PHC) setting in South Africa (SA).Method. Among 4 900 consecutively selected TB patients (54.5% men; women 45.5%) from 42 public PHC clinics in 3 districts in SA, a cross-sectional survey was performed to assess new TB and new TB retreatment patients within one month of anti-TB treatment.Results. The sample comprised 76.6% new TB patients and 23.4% TB retreatment patients. Of those who had tested for HIV, 59.9% were HIV-positive; 9.6% had never tested for HIV. In multivariate analysis, older age (odds ratio (OR) 5.86; confidence interval (CI) 4.07 - 8.44), female gender (OR 0.47; CI 0.37 - 0.59), residing in an informal settlement (OR 1.55; CI 1.13 - 2.12), being a TB retreatment patient (OR 0.55; CI 0.42 - 0.72), occasions of sexual intercourse with condom use (OR 1.07; CI 1.02 - 1.13) and having a sexual partner receiving antiretroviral treatment (ART) (OR 7.09, CI 4.35 - 11.57) were associated with an HIV-positive status in TB patients.Conclusion. This study revealed high HIV risk behaviour (e.g. unprotected last sexual intercourse and alcohol and drug use in the context of sexual intercourse) among TB patients in SA. Various factors were associated with HIV risk behaviour. Condom use and substance use risk reduction need to be considered as HIV-prevention measures when planning such strategies for TB patients.
Management of mental health disorders in HIV-positive patients
Authors: HIV Clinicians Society Southern African
Published: June 2017

These guidelines are intended as a reference document to assist HIV nurse and doctor clinicians in managing mental health disorders. It is intended to improve awareness, knowledge and capacity to support patients living with HIV and mental health disorders.
Impact of antiretroviral therapy on pregnancy outcomes
Authors: Aniji C D , Towobola Olakunle A , Hoque Muhammad Ehsanul , Mashamba T J , Monokoane Sam
Published: June 2017

Background.The majority of HIV-positive women in South Africa are of reproductive age, and pregnancies among women using antiretroviral therapy (ART) are common. However, there are mixed data regarding the impact of ART on pregnancy outcomes.Objective. To examine the impact of ART on pregnancy outcome according to the timing of initiation of treatment.Methods. A retrospective cohort study was conducted among women delivering at a tertiary hospital from 1 October 2008 to 31 March 2009.Results. A total of 245 mothers were receiving ART: 76 mothers (31%) started ART pre-conception and 169 mothers (69%) started ART after the first trimester. No significant differences were observed in the rates of preterm delivery and low birth weight (LBW) between the pre- and post-conception groups (21% v. 24% and 21% v. 25%, respectively).Conclusion. In this cohort of women receiving ART in pregnancy, timing of ART initiation did not have any adverse effect on the measured pregnancy outcomes such as preterm delivery and LBW.
Choice or no choice? The need for better branded public sector condoms in South Africa
Authors: Ashmore John , Henwood Ruth
Published: June 2017

Condoms are one of the cornerstones to any response to the HIV epidemic. However, targetedmarketing strategies that make condoms more attractive to people at high risk of infection areoften overlooked. The South African National Department of Health has recently purchasedmore attractive condoms to distribute in higher-education settings free of charge, targeting atriskyouth including young women. The authors applaud this move but note the importance ofexpanding better branded condoms to young people elsewhere – for example, via youth clinicsand in high schools. Exploratory, routine data from Médecins Sans Frontières in Khayelitshaare presented, showing the popularity of alternatives to the government’s ‘Choice’ brand.
Attracting, equipping and retaining young medical doctors in HIV vaccine science in South Africa
Authors: Flood Danna , Wallace Melissa , Bloch Kimberly , Kublin James , Bekker Linda-Gail
Published: June 2017

Background: HIV remains a significant health problem in South Africa (SA). The development of a preventive vaccine offers promise as a means of addressing the epidemic, yet development of the human resource capacity to facilitate such research in SA is not being sustained. The HIV Vaccine Trials Network (HVTN) has responded by establishing South African/HVTN AIDS Early Stage Investigator Programme (SHAPe), a programme to identify, train and retain clinician scientists in HIV vaccine research in SA.Objectives: The present study sought to identify factors influencing the attraction and retention of South African medical doctors in HIV vaccine research; to understand the support needed to ensure their success; and to inform further development of clinician research programmes, including SHAPe.Methods: Individual interviews and focus groups were held and audio-recorded with 18 senior and junior research investigators, and medical doctors not involved in research. Recordings were transcribed, and data were coded and analysed.Results: Findings highlighted the need for: (1) medical training programmes to include a greater focus on fostering interest and developing research skills, (2) a more clearly defined career pathway for individuals interested in clinical research, (3) an increase in programmes that coordinate and fund research, training and mentorship opportunities and (4) access to academic resources such as courses and libraries. Unstable funding sources and inadequate local funding support were identified as barriers to promoting HIV research careers.Conclusion: Expanding programmes that provide young investigators with funded research opportunities, mentoring, targeted training and professional development may help to build and sustain SA’s next generation of HIV vaccine and prevention scientists.
Antiretroviral therapy in adults
Authors: Office Editorial
Published: June 2017

No abstract available.
Treatment of HIV/AIDS in the managed care setting
Authors: McDonald Leighton
Published: June 2017

No abstract available.
The coming crime wave? AIDS, orphans and crime in South Africa
Authors: Schonteich Martin
Published: June 2017

No abstract available.
Antiretroviral therapy in adults: June 2002 version
Authors: Office Editorial
Published: June 2017

No abstract available.
A broken landscape
Authors: Mendel Gideon
Published: June 2017

No abstract available.
Medical management of a survivor of sexual assault/abuse
Authors: Wulfsohn Adrienne
Published: June 2017

No abstract available.
Mobilising communities
Authors: Bekker Linda-Gail
Published: June 2017

No abstract available.
Adherence issues
Authors: Bekker Linda-Gail
Published: June 2017

No abstract available.
Pre-ART Guidelines: Amended November 2004
Authors: Office Editorial
Published: June 2017

No abstract available.
HIV disclosure in children
Authors: Naeem-Sheik Aneesa , Gray Glenda
Published: June 2017

No abstract available.
AIDS : A Darwinian Event?
Authors: De Waal Alex , Whiteside Alan
Published: June 2017

No abstract available.
Guidelines for the prevention, diagnosis and management of cryptococcal meningitis and disseminated cryptococcosis in HIV-infected patients
Authors: McCarthy Kerrigan , Meintjes Graeme , Arthington-Skaggs Beth , Bicanic Tihana , Cotton Mark , Chiller Tom , Govender Nelesh , Harrison Tom , Karstaed Alan , Maartens Gary , Varavia Ebrahim , Venter Francois , Vismer Hester
Published: June 2017

No abstract available.
Antiretroviral therapy in adults -January 2008
Authors: Office Editorial
Published: June 2017

No abstract available.
Guidelines for renal replacement therapy in HIV-infected individuals in South Africa
Authors: Office Editorial
Published: June 2017

No abstract available.
Exercise capacity in pulmonary Tuberculosis
Authors: Hall M. , De Charmoy S.
Published: June 2017

Aims: To determine the exercise capacity of patients suffering from pulmonary tuberculosis infection and then compare thisvalue to the normal. To determine if the regression equation for TB is comparable to that of patients with chronic obstructive pulmonary disease(COPD). To provide guidelines for clinical practice of physiotherapyshould exercise capacity be found to be reduced. Methods: Thirteen black, male subjects between the ages of 19 and 35 years were included in the study. Each subject completed the shuttle walking test in order to determine his VO2peak. This was then compared to historical data for VO2peak. A subgroup of five subjects took part in a treadmill test to calculate a regression equation for VO2peak for TB patients. Results: Exercise capacity, measured as VO2peak, is reduced by an average of 57% when compared to the normal.The mean (SD) VO2peak for this group of thirteen patients is 19.09 (8.19)ml/kg/min. The shuttle walking test is a validand reliable test to determine the VO2peak of patients with pulmonary tuberculosis. Although a trend is evident the regression equation for pulmonary TB is based on a small sample size. Conclusion: Although the exercise capacity of patients with PTB is markedly reduced it does not seem to impact  on their function. Based on the above results, a preliminary recommendation is that a pulmonary rehabilitation program is not necessary for patients with pulmonary tuberculosis. Although not originally an aim of the study it isalso evident that the role of the physiotherapist with respect to pulmonary tuberculosis may be one of education.
The difference is in our hands
Authors: Eales C. J.
Published: June 2017

No abstract available
Prevalence of anterior knee pain among young South African basketball players
Authors: Louw Q.
Published: June 2017

The aim of the article is to provide an indication of anterior knee pain prevalence among young South African basketball players. A retrospective questionnaire survey was conducted to capture information on injuries sustained over one season. The sample comprised 458 young basketball players in Cape Town and comprised 122 club players and 337 school basketball players.  A total of 180 knee injuries were reported indicating a rate of 1 knee injury in 2.5 players. Anterior knee pain was the most commonly reported area ofpain by the 458 basketball players (49.1%, n=141). The most common combination of pain area was anteromedially (18.2%, n=141). The results of our survey are in agreement with other studies indicating that patellofemoral pain is probably the most common knee presentation among young active individuals and arguably the most common condition seen at sports injury clinics.
A pilot survey of the current scope of the practice of South African physiotherapists in the intensive care units
Authors: Van Aswegen H. , Patterson J.
Published: June 2017

Objective: A pilot study was conducted to determine the currentscope of practice of South African physiotherapists working in intensive care units in the government and the private sectors. These findings were compared to the findings from a European survey with regard to the role of the physiotherapist in European intensive care units.Methodology: Ninety questionnaires were distributed nationwide to secondary and tertiary government hospitals as well as to private practitioners involved in cardiopulmonary physiotherapy. The private practitioners included in this survey were listed in the Private Practitioners Association Official Members Directory. Junior and senior physiotherapists working in the intensive care units of their respective hospitals participated in completing the questionnaire. Comparisons between government and private sector data and between the South African survey and the European survey were carried out using the 2test for non-parametric data. A p-value of less than 0.05 was considered to be statistically significant.Results: Fifty-four questionnaires were analyzed and represented 60% of questionnaires sent out. Respondents to the South African survey reported 28% percent of all ICUs had between 9 - 12 beds; 83% physiotherapists indicated the availability of an on-call service during the night and 96% physiotherapists had a weekend physiotherapy service. Ninety-two percent of physiotherapists working in the government sector supervised students compared to 44% of physiotherapists in the private sector. Between 9% and 27% of physiotherapists in government and private hospitalsactively participated in research in ICU. There were no statistically significant differences in the use of respiratory physiotherapy, mobilization and positioning between respondents to the European survey and those of the South African survey respectively.Conclusion: The response rate to this questionnaire was good. It was evident from this pilot survey that the scope of practice of physiotherapy in ICU didn’t differ significantly between the government and private sector in South Africa. The role of the intensive care physiotherapist in South Africa was similar to that of the European physiotherapist  working in ICU.