Browsing by Subject "Adaptation"
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- ItemOpen AccessA systematic review of the psychometric properties of the cross-cultural translations and adaptations of the Multidimensional Perceived Social Support Scale (MSPSS)(BioMed Central, 2018-05-02) Dambi, Jermaine M; Corten, Lieselotte; Chiwaridzo, Matthew; Jack, Helen; Mlambo, Tecla; Jelsma, JenniferBackground Social support (SS) has been identified as an essential buffer to stressful life events. Consequently, there has been a surge in the evaluation of SS as a wellbeing indicator. The Multidimensional Perceived Social Support Scale (MSPSS) has evolved as one of the most extensively translated and validated social support outcome measures. Due to linguistic and cultural differences, there is need to test the psychometrics of the adapted versions. However, there is a paucity of systematic evidence of the psychometrics of adapted and translated versions of the MSPSS across settings. Objectives To understand the psychometric properties of the MSPSS for non-English speaking populations by conducting a systematic review of studies that examine the psychometric properties of non-English versions of the MSPSS. Methods We searched Africa-Wide Information, CINAHL, Medline and PsycINFO, for articles published in English on the translation and or validation of the MSPSS. Methodological quality and quality of psychometric properties of the retrieved translations were assessed using the COSMIN checklist and a validated quality assessment criterion, respectively. The two assessments were combined to produce the best level of evidence per language/translation. Results Seventy articles evaluating the MSPSS in 22 languages were retrieved. Most translations [16/22] were not rigorously translated (only solitary backward-forward translations were performed, reconciliation was poorly described, or were not pretested). There was poor evidence for structural validity, as confirmatory factor analysis was performed in only nine studies. Internal consistency was reported in all studies. Most attained a Cronbach’s alpha of at least 0.70 against a backdrop of fair methodological quality. There was poor evidence for construct validity. Conclusion There is limited evidence supporting the psychometric robustness of the translated versions of the MSPSS, and given the variability, the individual psychometrics of a translation must be considered prior to use. Responsiveness, measurement error and cut-off values should also be assessed to increase the clinical utility and psychometric robustness of the translated versions of the MSPSS. Trial registration PROSPERO-CRD42016052394.
- ItemOpen AccessAdapting an intervention of brief problem-solving therapy to improve the health of women with antenatal depressive symptoms in primary healthcare in rural Ethiopia(BioMed Central, 2022-09-09) Bitew, Tesera; Keynejad, Roxanne; Myers, Bronwyn; Honikman, Simone; Sorsdahl, Katherine; Hanlon, CharlotteBackground Evidence-based brief psychological interventions are safe and effective for the treatment of antenatal depressive symptoms. However, the adaptation of such interventions for low- and middle-income countries has not been prioritised. This study aimed to select and adapt a brief psychological intervention for women with antenatal depressive symptoms attending primary healthcare (PHC) in rural Ethiopia. Methods We employed the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. Alongside this, we used the ADAPT-ITT model of process adaptation and the ecological validity model (EVM) to guide content adaptation. We conducted formative work, comprising a qualitative study, a series of three participatory theories of change workshops and an expert adaptation workshop to assess the needs of the target population and to select an intervention for adaptation. The adaptation process followed a series of steps: (1) training Ethiopian mental health experts in the original South African problem-solving therapy (PST version 0.0) and an initial adaptation workshop leading to PST Version 1.0. (2) Version 1.0 was presented to perinatal women and healthcare professionals in the form of a ‘theatre test’, leading to further adaptations (version 2.0). (3) Local and international stakeholders reviewed version 2.0, leading to version 3.0, which was used to train 12 PHC staff using clinical cases. (4) Finally, feedback about PST version 3.0 and its delivery was obtained from PHC staff. Results In the first step, we modified case examples and terminology from the South African model, introduced an in-session pictorial flipchart for this low literacy setting, and added strategies to facilitate women’s engagement before translating into Amharic. In the second step, adaptations included renaming of the types of problems and inclusion of more exercises to demonstrate proposed coping strategies. In the third step, the components of motivational interviewing were dropped due to cultural incongruence. In the final step, refresher training was delivered as well as additional training on supporting control of women’s emotions to address PHC staff training needs, leading to the final version (version 4.0). Conclusion Using a series of steps, we have adapted the content and delivery of brief PST to fit the cultural context of this setting. The next step will be to assess the feasibility and acceptability of the intervention and its delivery in antenatal care settings.
- ItemOpen AccessDeveloping prehospital clinical practice guidelines for resource limited settings: why re-invent the wheel?(BioMed Central, 2018-02-05) McCaul, Michael; de Waal, Ben; Hodkinson, Peter; Pigoga, Jennifer L; Young, Taryn; Wallis, Lee AObjectives: Methods on developing new (de novo) clinical practice guidelines (CPGs) have received substantial attention. However, the volume of literature is not matched by research into alternative methods of CPG development using existing CPG documents—a specific issue for guideline development groups in low- and middle-income countries. We report on how we developed a context specific prehospital CPG using an alternative guideline development method. Difficulties experienced and lessons learnt in applying existing global guidelines’ recommendations to a national context are highlighted. Results: The project produced the first emergency care CPG for prehospital providers in Africa. It included > 270 CPGs and produced over 1000 recommendations for prehospital emergency care. We encountered various difficulties, including (1) applicability issues: few pre-hospital CPGs applicable to Africa, (2) evidence synthesis: heterogeneous levels of evidence classifications and (3) guideline quality. Learning points included (1) focusing on key CPGs and evidence mapping, (2) searching other resources for CPGs, (3) broad representation on CPG advisory boards and (4) transparency and knowledge translation. Re-inventing the wheel to produce CPGs is not always feasible. We hope this paper will encourage further projects to use existing CPGs in developing guidance to improve patient care in resource-limited settings.
- ItemOpen AccessNon-optimal apparent temperature and cardiovascular mortality: the association in Puducherry, India between 2011 and 2020(2023-02-08) Shrikhande, Shreya S; Pedder, Hugo; Röösli, Martin; Dalvie, Mohammad A; Lakshmanasamy, Ravivarman; Gasparrini, Antonio; Utzinger, Jürg; Cissé, GuéladioBackground Cardiovascular diseases (CVDs), the leading cause of death worldwide, are sensitive to temperature. In light of the reported climate change trends, it is important to understand the burden of CVDs attributable to temperature, both hot and cold. The association between CVDs and temperature is region-specific, with relatively few studies focusing on low-and middle-income countries. This study investigates this association in Puducherry, a district in southern India lying on the Bay of Bengal, for the first time. Methods Using in-hospital CVD mortality data and climate data from the Indian Meteorological Department, we analyzed the association between apparent temperature (Tapp) and in-hospital CVD mortalities in Puducherry between 2011 and 2020. We used a case-crossover model with a binomial likelihood distribution combined with a distributed lag non-linear model to capture the delayed and non-linear trends over a 21-day lag period to identify the optimal temperature range for Puducherry. The results are expressed as the fraction of CVD mortalities attributable to heat and cold, defined relative to the optimal temperature. We also performed stratified analyses to explore the associations between Tapp and age-and-sex, grouped and considered together, and different types of CVDs. Sensitivity analyses were performed, including using a quasi-Poisson time-series approach. Results We found that the optimal temperature range for Puducherry is between 30°C and 36°C with respect to CVDs. Both cold and hot non-optimal Tapp were associated with an increased risk of overall in-hospital CVD mortalities, resulting in a U-shaped association curve. Cumulatively, up to 17% of the CVD deaths could be attributable to non-optimal temperatures, with a slightly higher burden attributable to heat (9.1%) than cold (8.3%). We also found that males were more vulnerable to colder temperature; females above 60 years were more vulnerable to heat while females below 60 years were affected by both heat and cold. Mortality with cerebrovascular accidents was associated more with heat compared to cold, while ischemic heart diseases did not seem to be affected by temperature. Conclusion Both heat and cold contribute to the burden of CVDs attributable to non-optimal temperatures in the tropical Puducherry. Our study also identified the age-and-sex and CVD type differences in temperature attributable CVD mortalities. Further studies from India could identify regional associations, inform our understanding of the health implications of climate change in India and enhance the development of regional and contextual climate-health action-plans.
- ItemOpen AccessStates, agency, and power on the ‘peripheries': exploring the archaeology of the later Iron Age societies in precolonial Mberengwa, CE 1300-1600s(2021) Nyamushosho, Robert Tendai; Chirikure, ShadreckIn southern Africa, as elsewhere, the tendency of Iron Age (CE 200-1900) researchers has been to focus on the more prominent places on the landscape, especially those believed by pioneering archaeologists to have been centres of big states. Consequently, most research foci were accorded to Mapungubwe, Great Zimbabwe, Khami, Danamombe and many other places considered as centres (mizinda) of expansive territorial states. However, landscapes away from, and in-between these states and their centres are traditionally viewed as ‘peripheries' where resources that made them prosperous were extracted. The inhabitants of such ‘peripheries' are presented as if they possessed little or no agency. One such area is Mberengwa, a gold-rich area situated between the edges of Mapela, Mapungubwe, Great Zimbabwe, Danamombe, and Khami. This thesis explores the archaeology of Chumnungwa, a drystone-walled muzinda located in Mberengwa. Because of abundant gold, and a landscape optimal for cattle production and crop agriculture, Chumnungwa is often marginalised as a docile ‘periphery' of the more powerful and territorial states that surrounded it. Stratigraphic excavations were performed in different parts of the site to recover artefactual and chronological evidence. Indications are that the inhabitants of Chumnungwa exploited locally acquired resources such as gold, iron, and soapstone, but mixed these with resources from distant areas. Cumulatively, this evidence, when assessed in relation to chronology, suggests that Chumnungwa flourished more or less at the same time as Mapela, and the later phases of Mapungubwe, Great Zimbabwe, Khami, and Danamombe. As a powerful actor in Mberengwa, Chumnungwa also networked and was therefore entangled not only with local, but also with regional, and inter-regional politicoeconomic processes. This suggests it is only a historical invention that can marginalise some landscapes as ‘peripheral', especially in the absence of research, but once attention is directed to them, multiple layers of agency and entanglement emerge.
- ItemOpen AccessTechnical Analysis to Support the Adaptation Component of South Africa’s Second Nationally Determined Contribution(University of Cape Town, 2025) Taylor, Anna; Simpson, Nicholas; Sibanda, Darlington; Bhanye, Johannes; Trisos, Christopher; Moyo, Vuyisile; Matiza, Collins; Ouweneel, Birgitt; Cartwright, Anton; Blignaut, JamesResearch teams in the African Climate and Development Initiative (ACDI) and the Energy Systems Research Group (ESRG) at the University of Cape Town carried out analyses pertaining to climate change adaptation and mitigation as technical support to government in developing South Africa’s second Nationally Determined Contribution (NDC2) under the Paris Agreement. This technical report presents the adaptation component of the work, reviewing key climate change risks and adaptation efforts to date, proposing seven priority adaptation goals, and estimating the costs and benefits of 36 identified adaptation options that, if implemented well, would make a significant contribution to realising the goals. The seven proposed adaptation goals are: (1) Adapt South Africa’s water and sanitation systems to drying conditions and drought and flood intensification, as water underpins human, plant and animal health and all economic and livelihood activities; (2) Enhance disaster risk management, healthcare and sanitation provision, especially in informal settlements, to reduce impacts of flooding and heat stress on most vulnerable households; (3) Upgrade critical transport infrastructure (roads, rail, ports) to maintain functioning under increased rainfall intensity, heat stress, wind speeds and storm surges; (4) Enhance nutritious food access and affffordability through support to agricultural and fifisheries producers and distributors in adapting to warmer and windier conditions and changes in rainfall; (5) Enhance climate services, with early warning and impact information made accessible to a wide range of users, tailored to different operational, language, gender, age and disability needs; (6) Enhance ecosystem-based adaptation to heat and water stress, protecting South Africa’s natural heritage, biodiversity and improving ecosystem functioning that underpins our cultural identity, food systems, human wellbeing and tourism economy; and (7) Capacitate all spheres of government to implement adaptation through enacting and enforcing all provisions of the Climate Change Act. There is a companion technical report presenting the mitigation component of the work.
- ItemOpen AccessUsing Transformative Scenario Planning to think critically about the future of water in rural Jalna, India(2018-01-10) Kale, Eshwer; Khabiya, Pragati; Josh, VikasJalna, a drought-prone district in the Marathwada region of Maharashtra in India, faces serious water challenges. Some of the causes are recurrent drought, drought-like conditions and notable weather changes, crop loss and failure, and increasing demand for groundwater by farmers, industry and urbanisation, with declining groundwater levels. Water scarcity for domestic and livelihood needs of rural households is of grave concern. In recent times, thousands of families migrated to cities and towns in distress, in search of sustenance. While water requirements for industry and urban needs are met from the Jayakwadi dam, most of the rural population depends on declining groundwater and infrequent tankers in times of scarcity. At the same time, villages, NGOs and government have taken up water conservation projects, such as watershed development and the Mahatma Gandhi National Rural Employment Guarantee Scheme (MGNREGS), with encouraging results. Demand - side management practices, however, are poorly followed. Other practices, such as lifting safe groundwater into surface ‘farm ponds’, aggravate inequity and increase evaporation losses, while the improper implementation of land treatment projects affects the biophysical structure of land with long-term impacts on water availability. Finding sustainable solutions to this complex water issue is beyond the capacity of any single agency. It necessitates the active engagement of all stakeholders. Developed by Reos Partners, Transformative Scenario Planning (TSP) offers a neutral space for stakeholders to present their views, and construct a shared understanding of the situation and the actions they can take to address it. In short, TSP offers a way for social systems to get unstuck and move forward. This report provides an overview of the first TSP workshop titled Water Situation in Rural Jalna in 2030: For Domestic and Livelihood Needs’. It was presented by the Watershed Organisation Trust (WOTR) from 18 - 19 September 2017 at Krushi Vidnyan Kendra, Jalna, in the local language of Marathi.