South African Tuberculosis Vaccine Initiative

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    A decolonial approach to a socially just curriculum? a case study of a first-year common course in an emerging post-apartheid University eMzansi Afrika

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    This qualitative case study sought to explore whether and how the University of Mpumalanga (UMP) imagined social justice in its first-year common course, MIC100 (Mpumalanga in Context). The UMP is one of the only two universities established after apartheid in South Africa, and it does not have a colonial and apartheid history. However, its newness does not absolve the UMP from coloniality, thus the study found that the institution is implicated in coloniality due to its existence within a higher education environment that is pervasively Eurocentric. Thus, the study explored how the UMP worked with this complication through its curriculum in MIC100. Theories of social justice and decoloniality framed the study. While pointing out some of UMP's complicities in coloniality, the study found MIC100 to have made significant moves towards social justice and decolonization. The main data for this research was the students' reviews of MIC100, student interviews, and the UMP's documentary data which were analyzed on NVivo. Among the implications of the study, is the need and call for universities to be more intentional in responding to the decolonial question in ways that achieve social justice. Therefore, the findings reveal some of the strategies that were employed in MIC100 that can be adapted by educational institutions, lecturers, and curriculum designers. The strategies include efforts to recognize black students and their cultural products such as African languages; and creating teaching and learning environments where students can feel ayoba

    Genomic insights into Group A Streptococcus pathogenesis

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    Group A Streptococcus (GAS) is a bacterium responsible for invasive and non-invasive infections in humans. The sequela of an untreated or undertreated GAS pharyngitis include Rheumatic Fever (RF) and Rheumatic Heart Disease (RHD). Despite evidence for the effectiveness of antibiotics such as penicillin, the burden of GAS remains high in low- and middle-income countries (LMICs) compared to high-income countries (HIC), thus necessitating the development of innovative prevention tools and improve treatment strategies tailored to LMICs. However, the pathogenetic role of GAS is poorly understood. There remains limited studies conducted across Africa, compared with HICs, documenting virulence profiles associated with GAS infection, despite the fact that an increased burden of GAS is seen in LMICs. Only a few whole genome sequencing (WGS) studies in GAS have been conducted in Africa, but none have been performed in Southern Africa. To address this knowledge gap, first, I conducted evidence-based reviews on virulence factors in invasive GAS disease (study 1) and antimicrobial resistance (AMR) of GAS in LMICs (study 2). Thereafter, on a collection of invasive and non-invasive GAS isolates from Cape Town, South Africa, performed antimicrobial susceptibility testing (study 3) and employed WGS to identify the frequency of virulence factors and AMR determinants (study 4). In brief, I provide comprehensive evidence-based data linking hasA, speA, speK, and speG to invasive GAS infections, while factors like smeZ, ssa, and sic show inverse associations; document penicillin's continued high efficacy, alongside notable resistance to macrolides and tetracycline observed in LMICs; I demonstrate low levels of antimicrobial resistance in GAS in Cape Town, with most antibiotics being effective and only minimal resistance to macrolides and tetracycline; I report that GAS isolates from Cape Town exhibit a diverse range of virulence factors and AMR genes, with notable geographic variations. My research contributes to the growing evidence base to inform future efforts at global control of GAS infections. In addition to confirming antibiotic sensitivities peculiar to our setting, suggest that GAS profile variations should be taken into account to gain a deeper understanding of GAS infection in a local context

    Factors influencing cheetah (Acinonyx jubatus) distribution in Kafue National Park, Zambia

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    Globally, effective management of large carnivores, particularly threatened and endangered species like cheetah (Acinonyx jubatus), hinges upon a comprehensive understanding of their spatial distribution and conservation status. Despite being among the most threatened species within the Felid family, cheetah are data deficient throughout much of their known range, including within protected areas of Zambia, a potential stronghold for the species. In this study, existing camera trap data collected between 2018 and 2023, were used to assess cheetah occupancy estimates within Kafue National Park. These camera trap surveys were designed and run by the NGO Panthera Wildcat Conservation, in collaboration with Department of National Parks and Wildlife (DNPW) to estimate leopard density across the north, central, and southern regions of the park. To adapt this survey for use in cheetah occupancy analyses, I overlaid a 6 x 6 km grid cell onto the surveyed area (KNP), where each grid subsumed multiple camera traps stations, and was treated as an independent site. All subsequent analyses were conducted at this site level. Due to low detection of cheetah, I used a stacked occupancy model to analyse cheetah spatial distribution in relation to landscape/site covariates within KNP, interpreting the results as probability of site use rather than the true occupancy. Data on cheetah detection histories (presence and absence) were analysed against nine covariates, including closed versus open habitat types (namely open forest, closed forest and grassland), the relative abundance of both prey and other large predators (lion [Panthera leo] and spotted hyena [Crocuta Crocuta]), distance to water, anti–poaching patrol effort and distance to legal camps (lodges, NGO and DNPW bases). The results confirmed the presence of cheetah in KNP with 170 cheetah detections, 110 of which were independent. The detection probability for cheetah increased significantly with the sampling effort (total number of days cameras were active in a site) but the addition of other detection variables decreased the predictive performance of the models. The naïve occupancy varied from 28% in the south to 50% in the northern region. Similarly, cheetah detections were highest in the north and lowest in the south. Among the nine site covariates analysed, only prey RAI (β = 2.08), and proportion of open forest (β = –3.55) had a significant influence on cheetah probability of site use. Using cheetah by–catch data from a leopard survey provided a first estimate of cheetah occupancy in a Zambian National Park. These estimates could be improved through the addition of more sites and a longer survey duration (range: 80 –100 days) to improve estimates for this important carnivore species

    Training load metrics and responses of flatwater, ocean and river marathon kayakers in preparation for competition

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    Background: Regular training improves performance, particularly in activities like marathon kayaking, which require conditioning for both explosive bursts and sustained endurance efforts. Monitoring training load ensures a balance of physiological stress and recovery, which is critical for optimised improvement. However, there are currently no evidence-informed standards for monitoring training load in marathon kayaking. Aims & objectives: The aim is to identify the training load measures and metrics relevant to ocean, flatwater, and river marathon kayaking. This involves exploring low-cost, non-invasive monitoring methods and addressing existing gaps in our understanding of monitoring training load in marathon kayaking. The focus is on determining the effectiveness of these metrics in guiding physical conditioning and overall training performance. Ultimately, the goal is to contribute to the development of monitoring methods that are effective and tailored to the specific context. Methods: This dissertation had three parts: a systematic scoping review of the literature to identify the extent of the evidence around monitoring practices in marathon kayaking, followed by a more focused narrative review to more precisely highlight the specific demands of marathon kayaking and establish broad areas of importance. Using insights from the scoping and narrative reviews as a framework, a longitudinal repeated measures observational study was conducted with a cohort of marathon kayakers (n=38). The investigation used various low-cost, non-aversive, remotely deployable tools to monitor the kayakers' training for eight weeks before a race. Primary findings: Rating of perceived exertion (RPE) was the most sensitive measurement of session intensity. Furthermore, session RPE was considered the most reliable measure of overall training because it is RPE-derived and aligned with other training accumulation measures. Speed and heart rate were useful metrics with context, such as environmental conditions or when used as relative measures. Training stress can be examined by psychometric measures (DALDA and quick POMS). This cohort had relatively low levels of training stress, which had a minimal effect on the psychometric measures. Time trials are an effective performance measure where course environmental impacts can be mitigated. Conclusions: At present, there are practical, non-aversive metrics that provide valuable insights into various aspects of kayak training, including total volume, intensity, response, and performance evaluation. When used in the correct context, these metrics can be effective and well-suited to the needs of competitive kayakers

    A qualitative exploration of healthcare workers' perspectives on and experiences with colorectal cancer screening in the Western and Eastern Cape

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    In South Africa (SA), colorectal cancer (CRC) incidence and mortality is growing at an alarming rate. CRC is often diagnosed at an advanced stage in SA with a noted increase in younger diagnoses and poor outcomes. However, CRC screening and specifically faecal immunochemical testing (FIT) is not currently offered in the public healthcare sector in SA. Before implementing any sort of screening test, it is important to address health system related factors that are specific to the South African context to better understand the potential feasibility and acceptability of a screening test. To establish a foundation for the potential implementation of a FIT screening program, this qualitative study aimed to explore primary and secondary healthcare workers' perceptions of CRC screening. Materials and Methods: The PRECEDE portion of the PRECEDE-PROCEED model, which identifies predisposing (intrapersonal), reinforcing (interpersonal) and enabling (structural) constructs within the context of health behaviours, served as the theoretical framework for this study. Eight healthcare providers (n=6 physicians and n=2 nurses) practicing in both the Western and Eastern Cape were purposively sampled to participate in semi-structured qualitative interviews. Interviews were analysed using thematic analysis guided by the model. Results: Perceived barriers to CRC screening were identified as socioeconomic status, work status and personal discomfort with tests (predisposing); geographical challenges and healthcare worker related factors (reinforcing); and pathology lab services, test costs, lack of proper ablutions, and lack of clinical continuity and communication (enabling). Perceived facilitators were identified as health education (predisposing); primary care physicians' training in CRC risk and testing location (reinforcing); and test affordability, communication across different health systems, and test availability at primary care level (enabling). Conclusion: This study identifies context specific perceived barriers and facilitators among primary and secondary healthcare workers to CRC screening in South Africa. If CRC FIT screening were to be implemented in SA, relevant policy makers and stakeholders would need to address these perceived barriers across multiple levels

    A grounded theory exploration of how young autistic adults assigned female at Birth (AFAB) make meaning of friendships

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    Friendships are fundamental to human development and overall well-being. For autistic adults assigned female at birth (AFAB), navigating neurotypical norms and gendered expectations of friendship presents unique challenges, influencing how they understand, value, and experience friendships. Furthermore, autistic AFAB individuals belong to a stigmatised social group, additionally impacting their navigation of friendship. While there is increasing recognition of autistic AFAB adults' experiences, they remain underrepresented in autism due to historical diagnostic discrepancies. This study aims to address this gap by exploring how autistic AFAB individuals make meaning of their friendships, an area that is relatively unexplored. Using a constructivist grounded theory approach, nine semi-structured interviews were conducted with autistic AFAB individuals aged 19 to 28, all of whom had received a clinical autism diagnosis. Social Identity Theory (SIT) informed the analysis, emphasising how group membership as a stigmatised social identity shapes participants' sense of self. The study examined the nuanced ways autistic AFAB young adults assign meaning to friendships by exploring perceptions of friendship, their roles within these relationships, social expectations, and how their autistic identity influences these dynamics. The resulting theory reveals that autistic AFAB individuals construct meaning in their friendships through a dynamic and reciprocal interplay between their experiences of being autistic, social constructs of friendship, and their autistic identity. These elements, although distinct, are interconnected and continuously influence one another. As friendships evolve and individuals undergo personal growth, these processes intersect, shaping and reshaping the meaning and value ascribed to friendships over time. This research contributes to a more inclusive understanding of friendship by centring autistic AFAB individuals' perspectives. It offers critical insights to better support autistic AFAB young adults in fostering meaningful connections and it further challenges prevailing stereotypes about their relational capacities

    Mindsets: lived experiences of black actuarial science students

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    This qualitative study employed semi-structured interviews and an intersectionality lens to explore the experiences of six black actuarial science students at the University of Cape Town (UCT). With the underrepresentation of black African students in South Africa's actuarial science exacerbating societal imbalances, the research aims to unveil their experiences and factors shaping these students' mindsets. Mindsets are influenced by parental feedback, socioeconomic status, background, and socialisation, among other factors. At historically white UCT, challenges faced by black African actuarial science students stem from a clash between their diverse mindsets and the prevailing white-oriented academic environment. The study reveals that academic excellence and the desire to uplift families' socioeconomic status motivate students amid challenges tied to socioeconomic factors, language barriers, and disparate educational backgrounds. The mindset analysis reveals that prevalent discouragement, external expectations, and self-doubt rooted in predetermined negative beliefs foster a fixed mindset among these students. Conversely, factors fostering a growth mindset include resilience, determination, and socioeconomic motivations. Positive role models, supportive lecturers, and optimistic career prospects contribute to a growth-oriented perspective, emphasising individual agency, positive influences, and socioeconomic considerations. The findings underscore the urgent need for universities and actuarial science programmes to implement targeted support mechanisms addressing the unique challenges black actuarial science students face. The study advocates for increased racial representation, linguistic inclusivity, and socioeconomic equity within actuarial science, highlighting the importance of fostering a supportive, inclusive learning environment. Furthermore, it urges academic institutions to invest in mental health services to alleviate the emotional toll associated with actuarial science studies

    Ukushela: Men's ways of initiating romantic relationships

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    The initiation of romantic relationships has undergone significant transformation, especially with the rise of online platforms that have reshaped traditional courtship practices. Despite these evolving methods, gender roles continue to shape relationship formation, with societal expectations positioning men as initiators and women as responders. This qualitative study explored how men navigate the initiation of romantic relationships to see whether their approaches will reinforce or challenge dominant discourses of masculinity. Through focus group discussions with thirty male university students (ages 18-35) at the University of Cape Town, the research found that relationship initiation has shifted from formal, structured processes to more casual, everyday interactions. While participants acknowledged the potential benefits of equal participation in relationship formation, they also expressed resistance to changes in established gender practices, particularly regarding emotional expression and financial responsibilities. Young men experience significant pressure to conform to societal expectations of masculinity, both in face-to-face interactions and on digital platforms. These findings highlight how young men both reinforce and challenge dominant masculine discourses during relationship initiation, underscoring the tensions between evolving social norms and persistent gender expectations

    Experimental evaluation of the effect of thermal heat and pressure pre-treatment on primary sludge anaerobic digestion

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    Studies have proved that anaerobic digesters have been traditionally used for stabilization of sewage sludge before disposal. Methane and carbon dioxide are produced as by products bacterial synthesis of organic material in an oxygen deficient environment (Nopharatana et al., 1998). More recently development of the thermal hydrolysis process pre-treatment of sewage sludge has shown great economic and financial potential in terms of; an increased sludge degradability implying more biogas production, improved digestion rate, stable and highly efficient digester, improved dewaterability of sludge and finally pathogen free cake as a final product which can be used for soil conditioning. The generation of more biogas and class A biosolids would fit into the sustainable developments goals and is in line with the changing paradigms that involve resource recovery from waste. The research questions posed in this investigation is: How does thermal heat and pressure (THP) pre-treatment affect primary sludge input characteristics for anaerobic digestion (AD) process in completely mixed AD systems? The overarching aim of this study is to evaluate the effect of THP, with a reduced temperature and pressure (of 114°C and pressure 1.7 bars) on primary sludge (PS) degradability under Mesophilic (37°C) anaerobic digestion (AD) conditions. The specific objectives are: (i) comparison of selected anaerobic digester performance parameters for pre-treated and untreated primary sludges over the selected varying sludge retention times (SRTs) of 8, 10, 12, 15 and 30 days, (ii) determination of the unbiodegradable particulate fraction (fPS'up) for both the pre-treated and untreated primary sludge and their hydrolysis rates, (iii) complete elemental characterization stoichiometry and weak acid base chemistry for both primary sludges and (iv) graphical comparison of measured data and anaerobic digestion model-predicted results. The effect of thermal heat and pressure (THP) pre-treatment on primary sludge degradability was evaluated. Primary sludge was heated at 114°C at a pressure of 1.7 bars in a pressure cooker (model number 17995) for 1 hour and anaerobically digested. The degradability of the pre-treated primary sludge fed to the digester (Digester 2; D2) was compared to an identical control digester (Digester 1: D1) fed the same sludge without heat pre-treatment. Both digesters were operated for 30, 15, 12, 10 and 8 days SRT. The percentage of Chemical Oxygen Demand (COD) removal for D1 ranged from 17% a to 54%, while that of D2 ranged from 16% to 62% for 8 to 30 day SRT respectively, gas production per liter influent for D1 ranged from 1.94 liter gas/liter influent to 19.08 liter gas/liter influent while that for D2 ranged from 1.81 liter gas/liter influent to 20.01 liter gas/liter influent, methane gas composition for both D1 and D2 remains the same for all the sludge ages varying between 50%-69% for methane and 34% to 45% for carbon dioxide. This signifies stability in both digesters. The effluent volatile fatty acid (VFA) concentration is very low (less than 0.08 g COD/L) in concentration and notably below that measured in the influent for both digesters except for the 15-day SRT D2 which was taken as an outlier. The low effluent VFA concentration signifies stability of both digesters. A Ripley ratio of less than 0.4 in both digesters indicates stable conditions, (Jiang et al. 2012). The effluent H2CO3*Alk., and pH for both digesters D1 and D2 is similar ranging from 1167 to 1990 mg/ L CaCO3 and 1145 to 2016 mg/ L CaCO3 respectively at pH ranging from 6.77 to 7.16 and 6.83 to 7.08 for D1 and D2 respectively. These additional results qualitatively supported that the heat pre-treatment increased the degradability of the primary sludge. To quantify the increase in degradability by heat pre-treatment, the steady state anaerobic digestion (AD) model of Sötemann et al. (2005) was calibrated to the D2 and control D1 results. However, because the values of the measured methane production results were more consistent than the measured effluent COD concentration results, the AD was recast in terms of the methane gas production instead of the effluent COD concentration as the basis for calibration. With statistical curve fitting techniques, the unbiodegradable particulate organic (UPO) fraction of the primary sludge (fPS'up) and saturation (Contois) kinetics specific hydrolysis rate constants were determined for the control D1 AD to be 0.35, KM = 1.595 gCOD/(gCOD.d) and KS = 2.607 gCOD/L. While the KM and KS yield a faster hydrolysis rate than observed by Sötemann et al. (2005), the UPO fraction was closely the same (0.36). For the pre-heated sludge AD D2, the UPO fraction was 0.22 and saturation (Contois) kinetics specific hydrolysis rate constants were KM =1.474 gCOD/ (gCOD.d) and KS = 0.971 gCOD/L. From this it was concluded that the degradability of primary sludge PS was increased in two ways: (1) by converting some (~1/3rd) of the Unbiodegradable Particulate Organics (UPO) to Biodegradable Particulate Organics (BPO) and (2) increased hydrolysis rate of the BPO. The AD model of Sötemann et al. (2005) also comprises a stoichiometric section that is sequential to the part which calculates sludge breakdown (i.e., BPO utilized) via hydrolysis kinetics. This stoichiometric section is used to calculate the changes in H2CO3* Alk., FSA, partial pressure of the biogas and digester pH from the concentration and composition of the BPO utilized. Using this stoichiometric part in reverse, and assuming 100% carbon flux mass balance over the digesters, the composition of the used BPO was determined from the differences in the measured concentrations between influent and effluent. For the control digester D1, the BPO composition was found to be C1H0.647O0.065N0.063 and for D2 with heat pre-treatment it was C1H0.541O0.087N0.067. While these BPO compositions were similar for the D1 and D2 digesters, both are marked different to the BPO compositions previously observed by (Ekama, 2009) e.g. C1.0H2.0O0.571N0.052 by (Sötemann et al., 2005). The different BPO compositions than previously obtained is expected because the composition of the organics depends on the pollutants sources of the wastewater and could vary on a daily basis (Gaszynski, 2021). This research provides evidence that with THP pre-treatment the degradability of primary sludge is improved by increasing both the biodegradable fraction and the hydrolysis rate. However, because this is the first study to provide such evidence, it is recommended the further research be done which should include a method devised for validating the UPO composition (in this case it was set to be the same as observed in literature studies; (Gaszynski, 2021; Ekama et al., 2005). Such a method may involve batch AD of the sludge in question at a long solids retention time (>60d; All organics eventually degrade at very long sludge ages at but sludge ages of above 60d are deemed too high for considered design of AD systems (Sötemann et al., 2005)). Elemental analysis of influent and effluent sludges so that the calculated composition of the BPO is not dependent on the assumed composition of the UPO

    Exploring the development of the effective communication graduate attribute in the clinical technology programme at the Durban University of Technology: student, graduate, and educator perceptions and experiences

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    Effective communication (EC) between health professionals and patients is a core clinical skill and can be developed through the EC graduate attribute (GA). However, in South Africa, despite its adoption by higher education institutions and regulatory bodies, the development of this GA is not emphasised in most medical education programmes, including Clinical Technology (CT). This is partly due to a lack of consensus on how to integrate EC development into both practical and theoretical training. The limited research on students' perceptions, particularly in the global South and within CT, calls for an exploration of the phenomenon. This study, therefore, aimed to understand how the EC GA is developed through the perceptions and experiences of final-year students, new graduates, and academic and clinical educators in the CT programme at the Durban University of Technology. This study drew on Engeström's Activity Theory (AT). Since clinical training is situated and contextualised, it is susceptible to various influences. Encompassed within the AT is an understanding that context, in the form of the theory's components, influences how individuals experience EC development, making this theory suitable as an analytical lens. A qualitative methodology within an interpretivist paradigm was employed. This study adopted a phenomenological research design. Purposive sampling was used to select participants using three focus group discussions (ten final- year students and five new graduates) and ten semi-structured interviews (four academic and six clinical educators). The data analysis for the study was guided by Braun and Clarke's thematic analysis framework The findings revealed four key themes: (T1) Effective Communication as a Continuous Journey, (T2) Organisational Influences on EC Development, (T3) Navigating Cultural, Linguistic, and Interpersonal Dynamics, and (T4) Adapting Communication to Professional Practice. The findings suggest that the development of EC GA, as perceived by participants, often differed from prescribed institutional standards. Key influencing factors included clinical preparation, support structures, and language barriers. Additionally, a misalignment in how EC was conceptualised between students, academics, and clinical educators created further challenges. The study also highlighted the need for a multilingual language policy to enhance students' language proficiency and provide better support in diverse clinical settings in South Africa. This study therefore contributes to the broader discussion in health professions education about the collaborative development of GAs through authentic workplace learning, rather than sole reliance on formal instruction. This study also highlights the need for a re-evaluation of institutional policies on language, curriculum integration, and the importance of academic and clinical partnerships in conceptualising and developing the effective communication GA. Based on these findings, this study recommends introducing a formal communications module, the creation of a supportive learning environment through feedback and mentoring, revising curricula, and incorporating reflection for both educators and students to improve EC GA development

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