Building consensus in defining and conceptualizing acceptability of healthcare: A Delphi study.

BACKGROUND: The concept of healthcare acceptability is important for nursing staff spending most of their time with patients. Nevertheless, acceptability remains confusing without a collective definition in existing literature. OBJECTIVE: This study aimed to create a consensus among experts on definition and conceptual framework of healthcare acceptability. METHODS: We conducted two rounds of Delphi surveys to collect opinions from experts on definition and conceptual framework of healthcare acceptability proposed following thematic content analysis. We calculated the consensus among experts using the modified Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument and followed the guidance on conducting and reporting Delphi studies (CREDES) best practices. RESULTS: A total of 34 experts completed two rounds of Delphi survey. The definition was validated through consensus as: "a multi-construct concept describing the nonlinear cumulative combination in parts or in whole of experienced or anticipated specific healthcare from the relevant patients/participants, communities, providers/researchers or healthcare systems' managers and policy makers' perspectives in a given context." The overall quality rating was 92.6% and 95.1% for the proposed definition and conceptual framework respectively. CONCLUSION: Opinions collected from experts provided significant insights to build a consensus on healthcare acceptability advancing public health nursing.

A first observation of spermatogenesis in mature male scalloped hammerheads (Sphyrna lewini) from Zinkwazi, KwaZulu-Natal, South Africa.

Sharks are not only threatened, but also have a low fecundity as they are being overfished. The shark family, Sphyrnidae, consists of nine species of which three are found in South African oceans. One of the three Sphyrnidae species, the scalloped hammerhead (Sphyrna lewini) are the most common, but their biology and mode of reproduction are not extensively studied in terms of their reproductive biology. The aim of this study was to describe the germ cell development in the testes of sexually mature male scalloped hammerheads. Three individual male S. lewini were caught at Zinkwazi, KwaZulu-Natal, South Africa. The sharks and their reproductive organs were weighed and measured to collect the biometric data for the condition factor and the gonado-somatic index. Following standard necropsy, the testes were fixed in Bouin's solution and processed for histological assessment. The histological assessment revealed that the testes of S. lewini consist of seminiferous tubules which form part of a larger lobular structure with germ cells in different stages of development, from spermatogonia to mature spermatozoa. Seven stages of development were identified during the process of spermatogenesis, similar to what has been described for elasmobranchs. In conclusion, this study provides evidence that the testes of S. lewini are diametrical and polyspermatocystic and conforms to the testes structure of elasmobranch males.