Perspectives on academic mentorship, research collaborations, career advice and work-life balance: a masterclass conversation with Professor Salim Abdool Karim.

Mentorship and collaboration are fundamental to ensure success in research, particularly health research. In this article, we summarise a conversation between the Master's in Biostatistics students at Stellenbosch University and Professor Salim Abdool Karim, the head of the Centre for the AIDS Programme of Research in South Africa. In May 2021, Professor Abdool Karim was invited to share some of his expertise and knowledge on successful mentorship and collaboration with researchers in the early stages of their careers. Passion, hard work and always trying one's best were some of the key values he highlighted as what a young researcher would need to succeed in today's world. In this candid and open discussion, Professor Abdool Karim provides valuable insight pertaining to the intricacies of a career in research, in terms of collaboration, mentorship and personal lessons drawn from his own life experience.

Exploration of service centres for older persons in the Eastern Cape province, South Africa.

BACKGROUND: Service centres for older persons were set up in South Africa to implement programmes relating to the six determinants of the World Health Organization's (WHO) active ageing framework. The framework highlights the value of being physically active to prevent functional decline. OBJECTIVE: Our aim was to explore the characteristics of these centres and their members in the Eastern Cape province. METHOD: An exploratory, descriptive, cross-sectional design was utilised to explore the characteristics of 25 centres and the profiles of their managers and 275 members of these centres. RESULTS: The managers had no formal training. Health and social care system requirements were important in the province, but access to healthcare services was minimal, and managers were concerned about the physical environment. Over 50% of the centres provided meals (72%), social support services (60%), dance and aerobics (56%), blood glucose testing (52%) and guardianship for members without families (52%). The members reported multiple morbidities, including hypertension (59%), diabetes (16%) and arthritis (10.5%). Few members used tobacco (n = 20) and alcohol (n = 27), but most (n = 213) were afraid of falling although they went about their daily activities with minimal difficulties. Members were satisfied with their lives (n = 231). CONCLUSION: The centres provided platforms to enable the fulfilment of some of the goals of the WHO's active-ageing framework, but a comprehensive exploration of the centres and the members is needed. CLINICAL IMPLICATIONS: Physiotherapy, as part of interdisciplinary intervention, will promote the physical health of the members of the centres.

Career Development of Academic Staff in Faculties of Dentistry by Means of Mentorship Programs: Protocol for a Scoping Review.

BACKGROUND: Globally, the demands on dental educators continue to diversify and expand. Due to their importance and value, mentoring programs have been acknowledged as a means of recruiting, developing, and retaining academics in dental education. OBJECTIVE: This protocol is for a scoping review that aims to identify the goals of mentoring programs for academic staff in dental faculties and determine how these programs were structured, delivered, and evaluated. METHODS: The review will be performed in accordance with the Joanna Briggs Institute's methodology for scoping reviews, which covers both qualitative and quantitative scientific literature as well as grey literature written in English and published between 2000 and 2020. The databases will include PubMed, Ovid, the Educational Resources Information Center database, Science Direct, Scopus, Google Scholar, Trove, Web of Science, Openthesis.org, and the website of the American Dental Education Association. A manual search will also be conducted by using the reference lists of included studies to identify additional articles. Working independently, the authors will participate iteratively in literature screening, paper selection, and data extraction. Disagreements between the reviewers will be resolved by discussion until a consensus is reached or after consultation with the research team. Key information that is relevant to the review questions will be extracted from the selected articles and imported into a Microsoft Excel file. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) will be used to guide the reporting of this protocol. RESULTS: The search for appropriate literature has commenced, and we aim to present the results before the end of the 2021 academic year. CONCLUSIONS: The development of formal mentorship programs for academics in dental education will enhance the retention of academic staff. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/27239.

Impact of lived experiences of people with disabilities in the built environment in South Africa.

BACKGROUND: In spite of legislations and policies to ensure an inclusive society in South Africa for the accommodation of people with disabilities, there are reports that they still struggle to move freely within society. OBJECTIVES: As part of a larger qualitative exploratory study on the preparation of undergraduate civil engineering students in a local university to contribute to the development of an inclusive society, this article seeks to understand the impact of the lived experiences of people with disabilities in their interaction with the built environment. METHOD: Four persons with disabilities, considered to be knowledgeable about South African legislations relating to disability, were purposely selected to each share one specific experience whilst interacting with the built environment. The transcribed texts of the interviews were analysed by using the phenomenological-hermeneutic method. RESULTS: The participants exhibited strong desires to participate in society. However, the sense of loss of control and independence as they encountered challenges in the built environment changed the euphoria to disempowerment, rejection, anger and despondency. In spite of their experiences, participants expressed a commitment towards overcoming the challenges encountered in the broader interest of people with disabilities. CONCLUSION: A deeper understanding of the impact of the experiences of people with disabilities when they participate within the built environment in South Africa revealed a broad spectrum of negative emotions, which may impact the quality of life and well-being of the participants.

"What next now that you are sixty?" - Preliminary exploration of the self-reported aspirations of community-dwelling older persons in the Western Cape Province, South Africa within the active aging framework.

Future aspirations of older persons should interest professionals involved in health promotion services in view of World Health Organization's Active Aging Framework. With the South African government's plan to raise life expectancy to 70 years by 2030, there is likelihood that life expectancy at 60 years will increase. Future aspirations give motivations for living, with short and long-term goals to work toward. As part of a larger study exploring the profile of members of 35 Service Centers for Older Persons in the Western Cape Province, selected using stratified random sampling, this manuscript reports on the qualitative responses relating to the self-determined future aspirations of the members. Thematic analysis was utilized to explore the aspirations of 625 members, aged 60-100 years. The aspirations were classified into two, namely aspirations with and without possible future-oriented behavior. Separate six and three themes were identified respectively in the first and second categories of aspirations. Being members of centers meant to provide programs to enhance their future, an awareness of the future aspirations of older persons should inform the services provided to encourage older persons identify something to live for.

Impact of lived experiences of people with disabilities in the built environment in South Africa

Background: In spite of legislations and policies to ensure an inclusive society in South Africa for the accommodation of people with disabilities, there are reports that they still struggle to move freely within society. Objectives: As part of a larger qualitative exploratory study on the preparation of undergraduate civil engineering students in a local university to contribute to the development of an inclusive society, this article seeks to understand the impact of the lived experiences of people with disabilities in their interaction with the built environment. Method: Four persons with disabilities, considered to be knowledgeable about South African legislations relating to disability, were purposely selected to each share one specific experience whilst interacting with the built environment. The transcribed texts of the interviews were analysed by using the phenomenological­hermeneutic method. Results: The participants exhibited strong desires to participate in society. However, the sense of loss of control and independence as they encountered challenges in the built environment changed the euphoria to disempowerment, rejection, anger and despondency. In spite of their experiences, participants expressed a commitment towards overcoming the challenges encountered in the broader interest of people with disabilities. Conclusion: A deeper understanding of the impact of the experiences of people with disabilities when they participate within the built environment in South Africa revealed a broad spectrum of negative emotions, which may impact the quality of life and well-being of the participants

Disability prevalence-context matters: A descriptive community-based survey.

BACKGROUND: There is increasing interest in the collection of globally comparable disability data. Context may influence not only the rates but also the nature of disability, thus locally collected data may be of greater use in service delivery planning than national surveys. OBJECTIVES: The objective of this article was to explore the extent to which two areas, both under-resourced but geographically and socially distinct, differed in terms of the prevalence and patterns of disability. METHOD: A cross-sectional descriptive survey design was utilised, using stratified cluster sampling in two under-resourced communities in the Western Cape, South Africa. Nyanga is an informal urban settlement in Cape Town and Oudtshoorn is a semi-rural town. The Washington Group Short Set of questions was used to identify persons with disabilities (PWD), and a self-developed questionnaire obtained socio-demographic information. RESULTS: The overall prevalence of disability was 9.7% (confidence intervals [CIs] 9.7-9.8) and the proportion of PWD was significantly different between the two sites (Chi-Sq = 129.5, p < 0.001). In the urban area, the prevalence rate of any disability was 13.1% (CIs 12.0-14.3) with 0.3% (CIs 0.1-0.6) reporting inability to perform any function at all. In contrast, the semi-rural community had a lower overall prevalence rate of 6.8% (CIs 6.0% - 7.8%) but a higher rate of those unable to perform any function: 1% (CIs 0.07-1.4). Disability was associated with gender, age, unemployment and lower income status in both areas. CONCLUSION: Deprived areas tend to show higher disability prevalence rates than the National Census estimates. However, the discrepancy in prevalence and patterns of disability between the two under-resourced areas indicates the need for locally specific data when planning health interventions.

What can Sub-Saharan Africa learn from Canada's investment in active healthy ageing? A narrative view.

Background: The number of older persons in Sub-Saharan Africa is increasing. Aims: What can Sub-Saharan Africa learn from other countries that may enhance the health and wellness of older persons? Canada was conveniently selected as the country which has endorsed the need for action on active ageing, given that by 2026, 1 in every 5 Canadians will have reached the age of 65 years and 4% of the overall population will be 85 years and older. Methods: English language electronic searches of computerized databases (PubMed, MEDLINE, EMBASE, CINAHL, and PsychINFO) were done to locate relevant published studies on Canada, from January 2000 to August 2014. Keyword combination included: physical activity/activities, exercise/s, older person/s, elderly, ageing adults, seniors, and older people. Results: 8 out of 400 plus articles were reviewed, and 4 key approaches in ensuring active ageing in Canada were identified. From these, 5 public health-oriented plans are recommended for Sub-Saharan Africa: (1) there should be a shift in the conceptualisation of what physical activity entails, (2) it is necessary to build and strengthen collaboration between various stakeholders involved in planning, (3) raising awareness among older persons and the general population on the benefits in participating in physical activity, (4) encourage older persons to participate in culturally relevant physical activity, and (5) laying a better foundation for future generations of older persons. Conclusion: Though more elaborate planning is required, these recommended plans will contribute to achieving average life expectancy beyond 60 years in Sub-Saharan Africa.

Addressing change in physiotherapy education in South Africa.

BACKGROUND: Recent demands for the decolonisation of curriculum in South Africa present challenges to students, academics and other stakeholders. This resulted in tensions in tertiary institutions, cumulating in student-led protests. The authors hypothesised that the lack of shared understanding of what this unexplored process may entail contributed to the dilemma. OBJECTIVE: The aim of this opinion article is to highlight some of the possible contributors to the uncertainties in addressing this critical issue, especially as it relates to the demands for change in physiotherapy education. METHOD: To formulate our opinion, the authors reviewed literature relating to transformation in education in South Africa generally, and physiotherapy education specifically. RESULTS: While there is an opportunity to address the demand for change in physiotherapy education in South Africa, there is the possibility that the use of words, such as transformation, decolonisation and decoloniality, present different connotations to students and academics. CONCLUSION: It is of vital importance to create formal discourse which includes students, academics and other stakeholders that will facilitate shared understanding about what the previously unexplored and unmapped processes of engagement entail. The change process in physiotherapy education is envisaged to be a partnership between students and academic staff having common understanding about the processes and responsibilities, and must be addressed comprehensively. CLINICAL IMPLICATIONS: Aligning the change process in physiotherapy education with the decolonisation agenda will strengthen the South African health care system by ensuring that physiotherapy students are adequately prepared to provide service to patients within a context that acknowledges the uniqueness of South African communities.

The development and evaluation of content validity of the Zambia Spina Bifida Functional Measure: Preliminary studies.

BACKGROUND: Very little is known on outcome measures for children with spina bifida (SB) in Zambia. If rehabilitation professionals managing children with SB in Zambia and other parts of sub-Saharan Africa are to instigate measuring outcomes routinely, a tool has to be made available. The main objective of this study was to develop an appropriate and culturally sensitive instrument for evaluating the impact of the interventions on children with SB in Zambia. METHODS: A mixed design method was used for the study. Domains were identified retrospectively and confirmation was done through a systematic review study. Items were generated through semi-structured interviews and focus group discussions. Qualitative data were downloaded, translated into English, transcribed verbatim and presented. These were then placed into categories of the main domains of care deductively through the process of manifest content analysis. Descriptive statistics, alpha coefficient and index of content validity were calculated using SPSS. RESULTS: Self-care, mobility and social function were identified as main domains, while participation and communication were sub-domains. A total of 100 statements were generated and 78 items were selected deductively. An alpha coefficient of 0.98 was computed and experts judged the items. CONCLUSIONS: The new functional measure with an acceptable level of content validity titled Zambia Spina Bifida Functional Measure (ZSBFM) was developed. It was designed to evaluate effectiveness of interventions given to children with SB from the age of 6 months to 5 years. Psychometric properties of reliability and construct validity were tested and are reported in another study.

Locally manufactured wheelchairs in Tanzania - are users satisfied?

BACKGROUND: The government of Tanzania created opportunity for the production of wheelchairs that would be appropriate to the local needs and environment. OBJECTIVES: The study assessed the extent to which the wheelchairs met the activity and participation needs of the users, as well as the users' level of satisfaction with the provision, repair and maintenance of these wheelchairs. METHODS: A descriptive cross-sectional analytical design was utilized to collect data through the administration of a questionnaire among 75 adult wheelchair users. RESULTS: Participants had used wheelchairs for an average period of 9.3 years. Most participants (61%) had sustained spinal cord injuries, and used three-wheeler chairs (76%). More than 90% reported that their wheelchairs positively influenced their activity and participation needs, and 85% were satisfied with their ability to carry out daily activities. Participants expressed satisfaction with the durability of the wheelchairs (89%), and the professional services received (71%), but not with follow-up services (77%). There was difference in satisfaction with features of 3-wheeler and 4-wheeler rigid chairs (p=0.030). CONCLUSION: The wheelchairs positively impacted participants' activity and participation needs. Participants were sat isfied with the features of the wheelchairs but not with follow-up services. The concerns of dissatisfied users should be addressed.

Effectiveness of a home-based pulmonary rehabilitation programme in pulmonary function and health related quality of life for patients with pulmonary tuberculosis: a pilot study.

BACKGROUND: Patients with Pulmonary Tuberculosis (PTB) often develop impairment in pulmonary function due to anatomical changes secondary to the illness. Physiotherapy in the form of pulmonary rehabilitation has been advocated. OBJECTIVE: The aim of the study was to determine whether adherence to a six-week home-based pulmonary rehabilitation programme (PRP) improved the baseline measurements of lung function, exercise tolerance and health-related quality of life (HRQoL) in patients receiving out-patient treatment for PTB. METHOD: A single blinded randomized control study design was used to assess the effects of a six-week home- based PRP in patients receiving treatment for PTB at a local clinic in Khayelitsha, Western Cape. We evaluated lung function by spirometry (MINATO AUTOSPIRO-model no. AZ-505), exercise tolerance using the 6-min-walk test (6MWT), the Borg exercise exertion scale and HRQoL using the EQ-5 D questionnaire in an intervention group (n=34) and a control group (n=33). The trend of the effects of the PRP on lung function was towards increases, but there was no statistical difference between the intervention and control groups at the end of the sixth week in the values of FVC (p=0.2; 95% CI -0.9 to 0.51) as well as FEV1 (p=0.1; 95% CI -0.07 to 0.51). Similar trend was observed for exercise tolerance, and there was no significant difference in HRQoL (p=0.789). CONCLUSION: The outcome of the study provides motivation for further consideration and implementation of a pulmonary rehabilitation programme for patients with PTB.

The quality of life of people with leprosy-related residual impairment and disability in Malawi--is there a difference between people living in a leprosarium and those re-integrated into their communities?

INTRODUCTION: To compare the quality of life of people affected by leprosy living in a leprosarium and those reintegrated in communities in the southern region of Malawi. DESIGN: A translated version of the World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) was administered among two groups of people with leprosy-related residual impairment and disability living in either a leprosarium (male 47, female 53) or re-integrated into communities (male 41, female 57). The cross-sectional quantitative survey was conducted by trained Leprosy Control Assistants (LCAs). Descriptive statistics of mean and standard deviation were used to summarise the data while differences between the groups were evaluated using independent t-test. Level of significance was set at P < 0.05. RESULTS: Demographic data revealed that there were more residents of an older age in the leprosarium. There was no statistically significant differences in the WHOQOL-BREF mean scores between by those affected by leprosy living in the two contexts. Statistically significant differences existed in the psychological, physical and environmental domains when age and gender were used as confounding factors. CONCLUSIONS: We conclude that there is need to provide interventions that will encompass age and gender to all those affected by leprosy to improve their quality of life in both contexts.

Perception of risk of HIV and sexual risk behaviours among students in the United States, Turkey and South Africa.

The aim of this study was to examine HIV sexual risk behaviours and perception of HIV risk among 1 095 students from the United States of America (US), Turkey and South Africa. Randomly selected students who were enrolled in general education courses completed a structured questionnaire. Results revealed statistically significant differences in specific HIV-related sexual behaviours among students from the three countries and among male and female students in each country. A higher percentage of US and South African students engage in HIV risky sexual behaviours compared with their Turkish counterparts, and a higher percentage of female students in the US and South Africa engage in HIV sexual risk behaviours compared with their male colleagues. A higher proportion of Turkish male students engaged in sexual risk behaviours compared with their female counterparts. The perception of HIV risk was low among US and Turkish students, and high among South African students. There was no agreement between engaging in risky sexual behaviour and self-perception of HIV risk among South African female students, while agreement was poor for US male and female students, Turkish male and female students, and South African male students. The observed optimistic bias needs to be considered in the design and implementation of HIV prevention programmes for these populations.

Health-related quality of life (HRQoL) domains most valued by urban IsiXhosa-speaking people.

PURPOSE: The aim of the study was to investigate and identify aspects of health-related quality of life (HRQoL) that are most valued by IsiXhosa-speaking people resident in underresourced areas of Cape Town, South Africa. METHODOLOGY: Fifty-seven domains of HRQoL were identified as important through group discussions with IsiXhosa-speaking people. Participants randomly selected from the community (n = 601) and from individuals seeking medical attention at a local clinic (n = 102) graded the domains on a visual analogue scale (VAS) ranging from 0 for "not at all important" to 10 for " very important". The domains were then mapped to the categories of the International Classification of Functioning, Disability and Health. RESULTS: The domains regarded as being most important were Food availability [9.5, standard deviation (SD) = 1.52), Owning a brick house (9.4, SD = 1.57), Access to medical services (9.4, SD = 1.55) and Family safety (9.4, SD = 1.7). Having no bodily pain ranked 40th. Environmental Factors were valued significantly more than the other two categories, and those related to Body Functions were valued higher than domains in the category of Activity and Participation. DISCUSSION AND CONCLUSION: Despite being asked specifically to answer the questions in relation to their health status, the participants apparently did not differentiate between general quality of life (QoL) and specific HRQoL. It appears that members of an underresourced community regard socioeconomic and service delivery aspects of their lives as integral to their perceived state of health. It may be that it is not possible to separate out factors relating to general QoL from those specifically related to HRQoL in an underresourced population, and such populations might not be suitable for inclusion in certain clinical trials where an improvement in HRQoL is the required outcome. Alternatively, if an HRQoL instrument is to be used to monitor the impact of medical interventions, the inclusion of Environmental Factors should be considered.

Health-related quality of life (HRQoL) domains most valued by urban isiXhosa-speaking people.

PURPOSE: The aim of the study was to investigate and identify aspects of health-related quality of life (HRQoL) that are most valued by isiXhosa-speaking people resident in under-resourced areas of Cape Town. METHODOLOGY: Fifty-seven domains of HRQoL were identified as important through group discussions with isiXhosa-speaking people. Participants randomly selected from the community (n = 601) and from individuals seeking medical attention at a local clinic (n = 102) graded the domains on a visual analogue scale (VAS) ranging from 0 as "not at all important" to 10 as " very important". The domains were then mapped to the categories of the International Classification of Functioning, Disability, and Health. RESULTS: The domains regarded as being most important were food availability (9.5, SD = 1.52), owning a brick house (9.4, SD = 1.57), access to medical services (9.4, SD = 1.55), and family safety (9.4, SD = 1.7). Having no bodily pain was ranked 40th. Environmental factors were valued significantly more than the other two categories and those related to body functions were valued more highly than domains in the category of activity/participation. DISCUSSION AND CONCLUSION: Despite being asked specifically to answer the questions in relation to their health status, the participants apparently did not differentiate between general quality of life (QoL) and specific HRQoL. It appears that members of an under-resourced community regard socioeconomic and service delivery aspects of their lives as integral to their perceived state of health. It may be that it is not possible to separate factors relating to general quality of life from those specifically related to HRQoL in an under-resourced population and such populations might not be suitable for inclusion in certain clinical trials where improvement in HRQoL is the required outcome. Alternatively, if a HRQoL instrument is to be used to monitor the impact of medical intervention, the inclusion of environmental factors should be considered.

Are students in public high schools in South Africa physically active? Outcome of the 1st South African National Youth Risk Behaviour Survey.

BACKGROUND: The first Youth Risk Behaviour Survey in South Africa was carried out to establish the prevalence of key health risk behaviours among high school students. Though physical inactivity is a commonly reported contributory factor to chronic diseases of lifestyle in South Africa, there is no reliable national database on the participation of children and adolescents in physical activity. METHODS: This cross-sectional national prevalence study among students attending government schools in the nine provinces in South Africa utilized a two-stage cluster sample design. Statistical analysis allowed for clustered sampling, and data collected through self-administered questionnaire were weighted to reflect the underlying student population. RESULTS: Data of 10,699 participants were analyzed. More than one third (37.5%) of the students engaged in insufficient physical activity. By population group, a significantly lower proportion of white students (29.4%) than black (37.5%) and coloured students (45.6%) engaged in insufficient physical activity. Among those who abstained from participation, 25.9% were unwilling to participate, with significantly fewer white (26.8%) and black (25.1%) students feeling unsafe in their surroundings compared with coloured students (35.3%). Significantly fewer white students (5.6%) had no access to facilities compared to black students (17.0%). White students and students in higher grades reported lower rates of physical education classes at school. INTERPRETATION: Though the promotion of physical activity and healthy lifestyle is a national priority in South Africa, the survey indicates the need to pay attention to an appreciable proportion of high school students who do not participate sufficiently in physical activity.

Health promotion needs of physically disabled individuals with lower limb amputation in Rwanda.

PURPOSE: The objectives of the study were to identify the health-related behaviors among physically disabled individuals with lower limb amputation resident in Rwanda, the factors that influenced these behaviors, and the major issues that should be targeted in health promotion programs for physically disabled individuals with lower limb amputation. METHOD: A cross-sectional survey, utilizing a self-administered questionnaire, was carried out among 334 lower limb amputees who volunteered to take part in the study. In addition, a sub-sample of 15 participants was purposely selected for in-depth face-to-face interviews. RESULTS: Many participants did not engage in physical exercises (64.7%). Others abused alcohol on daily basis (14.4%), smoked 11-20 cigarettes daily (13.2%), and used recreational drugs such as marijuana, opium and cocaine (9.6%). There were significant associations between the age group of the participants and participation in exercises (P=0.001), and consuming alcohol, tobacco and recreational drugs (P=0.001). In-depth interviews revealed factors influencing the behavior of participants. CONCLUSIONS: Participants were found to be at risk of secondary complications because of poor lifestyle choices. There is a need to develop and promote wellness-enhancing behaviors in order to enhance the health status of physically disabled individuals in Rwanda who have lower limb amputations.

Perceived images of disability: the reflections of two undergraduate medical students in a university in South Africa on life in a wheelchair.

PURPOSE: The purpose of this manuscript is to document the experiences of two undergraduate medical students at the University of Cape Town, South Africa, who registered for a 4-week special study module titled "Images of Disability", as part of the medical training programme. The objective of the module was to foster the development of positive attitudes toward persons with physical disability through role-playing. METHOD: The special study module required that the students assumed they had mobility impairments and were physically confined to wheelchairs. The students were required to document their personal experiences of life in a wheelchair for five consecutive working days. RESULTS: The students had to deal with their perceptions of the attitudes of individuals they interacted with, which resulted in feeling of inferiority and lowered self-esteem. The students also identified obstacles in the environment which hindered integration. CONCLUSIONS: The students reported significant positive changes in their attitudes towards persons with disabilities.