Research Articles (University of Pretoria)

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This collection offers open access to the full text of research articles published by staff, students and affiliates of the University of Pretoria. These items are identical in content to their published counterparts. It is linked to the Research Information System and complements the Annual Research Report.

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Sustained competitive advantage and complexity : a configurational approach
(Academic Conferences International Limited, 2023-09) Rodríguez, José Carlos; Osuigwe, Ubochioma Udo S.; Mathibe, Motshedisi Sina; Calderón, Elisa; osuigweu@gibs.co.za
In recent years, Qualitative Comparative Analysis (QCA) has emerged as a research approach to get insight into social science and business complexity. In contrast to the inferential methods that measure the net effect of an independent variable into a dependent variable, the QCA approach uncovers the necessary and sufficient conditions leading to a desired outcome. This paper discusses complexity in social science and business from the QCA perspective. In this regard, there are three streams of literature in strategic management aiming to explain how some firms outperform others: Porter´s competitive advantage approach, Barney´s sustained competitive advantage perspective, and D´Aveni´s temporary advantage. However, the sustained competitive advantage approach suggests that generating economic rents must be understood as a complex phenomenon characterised by three features: i) path dependency (e.g., some resources and capabilities can only be developed over long periods, ii) social complexity (e.g., it may not always be clear how some firms develop some capabilities in short to medium term), and iii) causal ambiguity (e.g., some resources and capabilities cannot be bought and sold in markets). Therefore, this framework draws from a complex (or complexity) process that establishes logical connections between combinations of causal conditions (i.e., resources and capabilities) and a desired outcome (i.e., economic rents). The research methodology for business from the QCA perspective thus may raise some critical questions: How do some firms accumulate and deploy resources and capabilities more efficiently than their competitors to internally (not in markets) acquire and sustain a competitive advantage? And what is the nature of a firm´s economic rents? In short, this paper discusses the nature of sustained competitive advantage (i.e., desired outcome) as a complex process (and not as a linear process) in that some firms outperform others, managing and deploying different resources and capabilities (i.e., conditions).
Ubuntu leadership as a predictor of employee engagement : a South African study
(AOSIS, 2024-03-21) Chetty, Kerushan; Price, Gavin
ORIENTATION : Ubuntu leadership is increasingly being promoted as a suitable leadership philosophy for South African workplaces, necessitating further exploration of its application and outcomes. RESEARCH PURPOSE : This study thus investigates Ubuntu leadership as a predictor of employee engagement (EE) in the South African context, considering ethnicity, age and tenure as moderating variables. MOTIVATION FOR THE STUDY : The necessity to study perceptions of Ubuntu leadership and its influence of EE lies in the need to understand how this culturally rooted leadership style can enhance organisational performance, employee well-being and inclusivity in diverse workplaces. RESEARCH APPROACH/DESIGN AND METHOD : The study adhered to a positivist philosophical perspective, employing a descriptive research design with a quantitative approach. Data were collected from 193 South African participants through a self-administered online questionnaire. MAIN FINDINGS : The study findings indicated that the practice of Ubuntu leadership, as perceived by employees, significantly predicted EE. PRACTICAL/MANAGERIAL IMPLICATIONS : Organisational leaders and managers hold a crucial role in shaping the workplace environment, and their acknowledgment of Ubuntu leadership’s fundamental principles, such as fostering authentic relationships, empathy, collaboration and respect, has the potential to boost EE. CONTRIBUTION/VALUE-ADD : The research outcomes offer valuable insights into how Ubuntu leadership can enhance EE and provide proactive measures for its implementation.
Update on the pharmacological management of neurodegenerative diseases : Alzheimer's disease
(Medpharm Publications, 2024) Flepisi, Brian Thabile; Hanser, S.; Balmith, Marissa; brian.flepisi@up.ac.za
Neurodegenerative diseases (NDDs) are the most common causes of morbidity and cognitive impairment, particularly among the elderly population worldwide. Due to increasing life expectancy, there has been an increase in the prevalence of NDDs. One of the most common NDDs is Alzheimer’s disease (AD), which is characterised by a complex, multifactorial irreversible aetiology, including the progressive loss of neurons. It is also the most common cause of dementia. Pathologically, AD is associated with the presence of amyloid plaques and intracellular neurofibrillary tangles. The management of AD focuses mainly on establishing an early, accurate clinical diagnosis, early drug administration, treatment of comorbidities and dementia-related complications, as well as treatment of behavioural and psychological symptoms. There is currently no cure for AD, and the currently United States Food and Drug Administration (US-FDA) approved drugs only offer symptomatic relief aiming to improve cognitive and behavioural symptoms; however, they do not target the underlying AD pathology or prevent neuronal degeneration. The current US-FDA approved drugs used for the management of AD include acetylcholinesterase inhibitors (donepezil, galantamine, and rivastigmine), N-methyl-D-aspartate (NMDA) receptor antagonist (memantine), and monoclonal antibody against Aβ (Lecanemab). It should be noted that all these approved drugs only assist in the management of symptoms; however, they do not prevent neuronal loss, brain atrophy, and progressive deterioration of cognition associated with AD. To curb the increasing prevalence of AD, new therapeutic strategies are required, including the development of gene therapy, drugs targeting Aβ, and drugs targeting neuronal hyperexcitability among others.
Assessment of teaching strategies and learning style preferences of lecturers and oral hygiene students at a higher education institution in South Africa
(South African Dental Association, 2024) Morule, M.; Bhayat, Ahmed; Madiba, Thomas Khomotjo; Nkambule, Ntombizodwa Rosemary; Mgabe, N.
INTRODUCTION : Lecturers and students at tertiary institutions have different teaching strategies and learning styles (TS&LS) and it is essential to align these strategies and styles to ensure that students understand the concepts they are taught. This study was conducted to assess and compare the TS&LS preferences among lecturers and undergraduate oral hygiene students at a university in South Africa. METHODS : A cross-sectional study was conducted, inviting all full-time lecturers (35) and undergraduate dental hygiene students (40) registered for the 2021 academic year to participate. The visual, auditory, reading and kinesthetic (VARK) teaching and learning questionnaires (version 7.8) for lecturers and students respectively was utilised to capture the necessary information. This is a validated questionnaire and consists of a variety of questions which students complete using a multiple-choice approach. SPSS statistical package, version 27 was used for statistical analysis with a significance of p< 0.05. RESULTS : Twenty-seven (27) lecturers (77%) and 40 students (100%) completed the questionnaire. The highest mean teaching scores were in visual (6.44) and auditory (6.22) teaching styles. The highest mean learning scores was auditory (6.43) and visual (5.98). The kinesthetic sensory modality constituted the lowest mean score in both lecturers and students. The majority of lecturers (63%) preferred using a single mode of teaching while 77% of students preferred learning using a multimode approach. CONCLUSIONS : The most common teaching and learning scores corresponded with each other. The preferred teaching strategy of lecturers was unimodal while the majority of students preferred a multimodal means of teaching. As a result, to improve student understanding and learning lecturers should use multimodal means of teaching.
An assessment of Western Cape metro public dental clinics’ compliance with the primary healthcare package for South Africa : a set of norms and standards
(South African Dental Association, 2024-11) Mohamed-Jacobs, A.; Bookhan, Vinesh; Mkhize, N.M.; Madiba, Thomas Khomotjo
INTRODUCTION: This study explores the compliance of public dental clinics in the Western Cape Metro (WCM), South Africa with the Primary Healthcare Package for South Africa AIMS AND OBJECTIVES : The study evaluates the availability of prescribed dental consumables, instruments and equipment in primary oral health clinics. Additionally, it seeks to determine the number of clinics providing the basic package of oral health services. DESIGN : A cross-sectional study METHODS : This study conducted an audit of 28 public dental clinics in the Western Cape metro. Full-time clinic staff were surveyed using a questionnaire. Equipment and materials were assessed using a checklist. Data analysis was performed using SPSS version 28, summarising quantitative variables with proportions, frequencies, means and standard deviations RESULTS : A total of 15 clinics responded out of the 28 invited with a response rate of 53.6%. Only two clinics offered all services in the basic package of care. Eleven clinics had 80% or more of the required equipment. Ten clinics had 80% or more of the required instruments used to treat pain and sepsis. All the clinics had at least 80% of the required consumables CONCLUSION : None of the clinics was compliant with national norms and standards.
The misuse of analgesics and nonsteroidal anti-inflammatories in runners
(Medpharm Publications, 2024) Esterhuizen, C.; Cordier, Werner
Global participation in running has continued to grow over the last decade, with millions of people running weekly, regardless of distance. These events, particularly endurance running events, require months of progressive training and load adjustment, which, combined with other factors, increase the risk of developing running-related injuries. Inflammation is a natural biological response important for healing in musculoskeletal tissue; however, it may also contribute to the unpleasant experience of pain. Runners may suffer from exercise-induced pain and inflammation, necessitating using analgesics and nonsteroidal anti-inflammatories. Unfortunately, the inappropriate use of these drugs is frequently seen in athletes, which may impact their recovery after injury or general health status. This review presents in brief the current knowledge of running-related pathology and treatment thereof, including considerations of its misuse.
The impact of unprofessional behaviour on patient safety in South Africa : two cautionary tales
(Medpharm Publications, 2024) Schellack, Natalie; Maimin, J.; Kriel, M.; Moodley, S.; Padayachee, N.; natalie.schellack@up.ac.za
In terms of the Rules relating to the Code of Conduct, every pharmacist’s prime concern in the performance of his/her professional duties must be for the wellbeing of both the patient and other members of the public. A pharmacist must uphold the honour and dignity of the profession and may not engage in any activity which could bring the profession into disrepute.Pharmacists engaging in unprofessional conduct or conduct where their regard for their profession is disrespectful, may be involved in activities such as the selling of counterfeit medicines, dispensing medication without prescription, and selling excessive quantities of medicines liable for misuse or abuse, i.e. drug trafficking. These actions can be attributed to factors such as financial incentives, inadequate training, or personal challenges, none of which are acceptable. These pharmacists are viewed as rogue pharmacists with severe implications for patient safety and significant risk of bringing the profession into disrepute.There are also instances where pharmacists make dispensing errors, supplying incorrect medicines, incorrect strength of medicines or incorrect dosage instructions. These errors are generally inadvertent but can obviously have a negative impact on patient safety. As the custodian of medicine, it is crucial that the pharmacist makes every effort to prevent medication errors. Pharmacists must be aware of areas where the chances of dispensing errors are high, especially those caused by look-alike sound-alike (LASA) medications, as they can lead to adverse reactions or even death. Preventing LASA medication errors requires awareness, generic prescribing, pop-up alerts in computer systems, eye-catching labels and warnings, patient education, and the establishment of process and outcome measures. Pharmacists can also organise high-risk LASA drugs on separate shelves and implement double-checking systems for accuracy when dispensing medications.Dispensing errors can have severe consequences for the pharmacist, including monetary fines, registration suspension or removal, and public scrutiny. The misuse and abuse of codeine-containing medications pose significant health risks and pharmacists play a crucial role in harm reduction.Measures to address codeine overuse, misuse and abuse include enhanced regulatory measures, public health interventions, surveillance,training, and education. Without some form of centralised database, it is very challenging for a pharmacist to manage this problem as individuals utilise different pharmacies and their medication history is not linked. To address this problem, pharmacists can participate in initiatives such as the Codeine Care Initiative, a centralised data base of codeine-containing medicine use. This allows the monitoring of frequent purchasers of codeine and gives the pharmacist an opportunity to address codeine misuse at the point of dispensing.
Stepping up : a pharmacist’s role in managing diabetes and foot ulcers
(Medpharm Publications, 2024) Mlambo, Shamiso Shelter; Ncube, Keith Ntokozo; Parkar, Hafiza; shamiso.mlambo@up.ac.za
Diabetes mellitus (DM) is a significant global health problem, with over 537 million adults affected in 2021. A crucial complication of DM is diabetic foot ulcers (DFUs), which result from nerve damage and impaired circulation, leading to loss of function and high medical costs. The role of pharmacists in managing diabetes and DFUs has evolved from strictly dispensing medication to being healthcare providers that are actively involved in patient education on glycaemic control, wound care strategies, and promotion of medication adherence. Treatment of DFUs is mainly focused on maintaining a moist wound environment, preventing infection and pressure offloading. This article highlights the essential role of pharmacists in a multidisciplinary healthcare team to enhance patient outcomes by applying their expertise to reduce diabetes-related complications such as DFUs.
Care and compassion in healthcare provision
(South African Dental Association, 2024-09) Sykes, Leanne M.; Bester, Janette; leanne.sykes@up.ac.za
The quality of patient care forms the basis of all doctor-patient relationships. However, it requires more than mere provision of what is necessary to maintain or restore their health, and should encompass an emotional connection, and a desire to help them. Care covers a wide range of activities and is often seen as the technical and procedural aspects of medicine, while compassion revolves around the relational aspects of patient care. It requires clinicians to be able to express empathy and understanding, share their patients' feelings, be available, communicate, try to provide support and encouragement, and treat them with respect and dignity. This paper discusses care and compassion and explores issues such as whether a person can be taught to care and/ or show compassion; if too much compassion could cloud a practitioner's judgement; if it's possible to deliver good care without being compassionate; and whether a person who has never experienced compassion can develop this ability. Care and compassion are essential components of effective medical practice, and need to be integrated into healthcare. Clinicians should adopt a patient-centred approach that prioritises the patient's values, needs and preferences during their decision-making process. At the same time, they must cultivate emotional intelligence, and identify when they need mental, emotional or physical support.
Comparing 68Ga-Pentixafor,18F-FDG PET/CT and chemokine receptor 4 immunohistochemistry staining in breast cancer : a prospective cross sectional study
(MDPI, 2025-03) Hadebe, Bawinile; Harry, Lerwine; Gabela, Lerato; Nxasana, Thembelihle; Ndlovu, Nontobeko; Pillay, Venesen; Masikane, Siphelele; Patel, Maryam; Mpanya, Dineo; Buccimaza, Ines; Msimang, Mpumelelo; Aldous, Colleen; Sathekge, Mike Machaba; Vorster, Mariza
BACKGROUND : CXCR4 is a chemokine receptor that is frequently overexpressed in invasive breast cancer and plays a major role in tumor proliferation, aggressiveness and metastasis. The aim of this prospective study was to establish the value of CXCR4-directed PET imaging in patients with breast cancer using the novel CXCR4-targeted PET probe 68Ga-Pentixafor by comparing it with 18F-FDG PET/CT (n = 40). MATERIALS AND METHODS : In this prospective cross-sectional study, fifty-one patients with breast cancer aged 36–81 (median (Q1-Q3) 51 (42.5–63)), n = 47 (92%) with initially diagnosed and n = 4 (8%) patients with recurrent breast cancer, underwent CXCR4-targeted PET imaging using 68Ga-Pentixafor. Maximum standardized uptake values (SUVmax), total lesion glycolysis (TLG) or total lesion uptake (TLU), metabolic tumor volume (MTV) and tumor-to-background ratios (TBR) of tumor lesions were measured and correlated with pathological prognostic factors, molecular subtypes and CXCR4 immunohistochemistry (IHC) staining. 18F-FDG PET/CT images were available in 40 of 51 cases (82%) and were compared semi-quantitatively. The patients were followed up for a median of 11 months (range 4–80 months) to determine whether CXCR4 expression correlated with survival. RESULTS : 68Ga-Pentixafor-PET/CT was visually positive in 49/51 (96%) of the cases; in addition, [18F]FDG demonstrated a higher SUVmax compared to 68Ga-Pentixafor. The mean SUVmax was 7.26 ± 2.84 and 18.8 ± 9.1 for 68Ga-Pentixafor and [18F]FDG, respectively. Thirty-seven percent (18/51) of patients had triple-negative breast cancer and 25/51 (49%) had estrogen receptor (ER+) disease. There was a statistically significant correlation between tumor grade, proliferative index (Ki-67) and SUVmax obtained from 68Ga-Pentixafor PET p = 0.002. There was no correlation between the SUVmax obtained from 68Ga-Pentixafor and PET molecular subtypes, estrogen receptor (ER), progesterone receptor (PR) or human epidermal growth factor receptor 2 (HER2) status; however, triple-negative breast cancers had more avid 68Ga-Pentixafor accumulation compared to luminals A and B. The median (Q1–Q3) 68Ga-Pentixafor TLU was significantly higher in HIV-positive (376 (219–881)) compared to HIV-negative (174 (105–557)) breast cancer patients. CONCLUSIONS : In conclusion, 68Ga-Pentixafor had a sensitivity of 96% and a specificity of 100% for detecting primary breast cancer; in addition, 68Ga-Pentixafor exhibited significantly higher uptake in patients with higher tumor grade, high proliferative index and triple-negative breast cancer (TNBC), as well as HIV-infected breast cancer patients, highlighting the potential clinical utility and prognostic role of CXCR4-targeted PET imaging in aggressive breast cancer. Notably, 68Ga-Pentixafor complements 18F-FDG by detecting more metastasis in the brain and the skull where FDG has limitations, while 18F-FDG remains superior for detecting skeletal metastasis. Future research should further explore the potential of CXCR4-targeted PET imaging in selecting patients with triple-negative breast cancer and high-grade breast cancer who may benefit from CXCR4-targeted therapies, particularly in the context of HIV co-infection.
Patients with cervical cancer with and without HIV infection have unique T-cell activation profiles despite similar survival outcomes after chemoradiation
(American Association for Cancer Research, 2025-04) MacDuffie, Emily C.; Cocka, Luis; Lin, Xiang; Bvochora-Nsingo, Memory; Chiyapo, Sebathu; Balang, Dawn; Maswabi, Bokang; Ngoni, Kebatshabile; Ramogola-Masire, Doreen; Zetola, Nicola M.; Wei, Zhi; Shen, Hao; Bassa, Sheynaz; Grover, Surbhi; Robertson, Erle S.
The global burden of cervical cancer is highest in low- and middle-income countries. Women living with human immunodeficiency virus (HIV) infection are particularly affected by cervical cancer despite availability and adherence to antiretroviral therapy. Immune profile correlates of survival and treatment response have not been widely explored in patients with and without HIV infection. This study recruited women with cervical cancer undergoing definitive chemoradiation (CRT) in Botswana. Clinical characteristics and blood samples were collected. Flow cytometry was performed on samples prior to initiation, at completion, and 3 months after CRT. Logistic regression analysis identified immune markers that differed by HIV status and correlated with overall survival (OS). The study enrolled 131 consecutive women (HIV+ N = 89 and HIV− N = 42). From initiation to 3 months after CRT, a significant decrease in CD4 frequency (72%–60.55%, P < 0.001) and an increase in CD8 frequency (20.9%–31.5%, P < 0.001) were seen in women without HIV, whereas no significant changes in CD4 frequency (52.5%–50.9%) or CD8 frequency (39.9%–41.4%) were observed in those with HIV. Peripheral T cells underwent similar activation across the cohort regardless of HIV status. Improved OS was associated with reduced frequency of IL-2–expressing CD4 T-cell subsets. In women living with HIV, enhanced OS was associated with the presence of proinflammatory CD8 T cells. CRT induces peripheral T-cell activation and distinct cytokine profiles that differ by HIV status. Despite similar OS, HIV infection may differentially affect immune response to CRT in women with well-managed HIV. SIGNIFICANCE : Chemoradiation affects the immune system of patients with cervical cancer with well-controlled HIV infection differently than those without HIV, yet their survival does not differ. This finding is an important step in understanding how management of HIV infection can modify cancer outcomes, particularly in settings with a high burden of HIV.
The germline and somatic origins of prostate cancer heterogeneity
(American Association for Cancer Research, 2025-05) Yamaguchi, Takafumi N.; Houlahan, Kathleen E.; Zhu, Helen; Kurganovs, Natalie; Livingstone, Julie; Fox, Natalie S.; Yuan, Jiapei; Sietsma Penington, Jocelyn; Jung, Chol-Hee; Schwarz, Tommer; Jaratlerdsiri, Weerachai; Van Riet, Job; Georgeson, Peter; Mangiola, Stefano; Taraszka, Kodi; Lesurf, Robert; Jiang, Jue; Chow, Ken; Heisler, Lawrence E.; Shiah, Yu-Jia; Ramanand, Susmita G.; Clarkson, Michael J.; Nguyen, Anne; Espiritu, Shadrielle Melijah G.; Stuchbery, Ryan; Jovelin, Richard; Huang, Vincent; Bell, Connor; O'Connor, Edward; Mccoy, Patrick J.; Lalansingh, Christopher M.; Cmero, Marek; Salcedo, Adriana; Chan, Eva K.F.; Liu, Lydia Y.; Stricker, Phillip D.; Bhandari, Vinayak; Bornman, Maria S. (Riana); Sendorek, Dorota H.S.; Lonie, Andrew; Park, Daniel J.; Hovington, Helene; Kerger, Michael; Bergeron, Alain; Sabelnykova, Veronica; Seo, Ji-Heui; Pomerantz, Mark M.; Zaitlen, Noah; Waszak, Sebastian M.; Gusev, Alexander; Lacombe, Louis; Fradet, Yves; Ryan, Andrew; Kishan, Amar U.; Lolkema, Martijn P.; Weischenfeldt, Joachim; Tetu, Bernard; Costello, Anthony J.; Hayes, Vanessa M.; Hung, Rayjean J.; He, Housheng H.; McPherson, John D.; Pasaniuc, Bogdan; Van der Kwast, Theodorus; Papenfuss, Anthony T.; Freedman, Matthew L.; Pope, Bernard J.; Bristow, Robert G.; Mani, Ram S.; Corcoran, Niall M.; Reimand, Jueri; Hovens, Christopher M.; Boutros, Paul C.
Newly diagnosed prostate cancers differ dramatically in mutational composition and lethality. The most accurate clinical predictor of lethality is tumor tissue architecture, quantified as tumor grade. To interrogate the evolutionary origins of prostate cancer heterogeneity, we analyzed 666 prostate tumor whole genomes. We identified a compendium of 223 recurrently mutated driver regions, most influencing downstream mutational processes and gene expression. We identified and validated individual germline variants that predispose tumors to acquire specific somatic driver mutations: these explain heterogeneity in disease presentation and ancestry differences. High-grade tumors have a superset of the drivers in lower-grade tumors, including increased frequency of BRCA2 and MYC mutations. Grade-associated driver mutations occur early in tumor evolution, and their earlier occurrence strongly predicts cancer relapse and metastasis. Our data suggest high- and low-grade prostate tumors both emerge from a common premalignant field, influenced by germline genomic context and stochastic mutation timing. SIGNIFICANCE : This study uncovered 223 recurrently mutated driver regions using the largest cohort of prostate tumors to date. It reveals associations between germline SNPs, somatic drivers, and tumor aggression, offering significant insights into how prostate tumor evolution is shaped by germline factors and the timing of somatic mutations.
Accounting for renewable energy : investigating emerging topics and research pathways
(Wiley, 2025-05) De Villiers, Charl Johannes; Principale, Salvatore; Galeotti, Rubina Michela; Cicchini, Daniela
This paper presents a structured and systematic literature review (SLR) and critique of the literature on the opportunities and challenges of accounting, auditing, and renewable energy sources to identify trends and research streams and construct an agenda for future research. We collected a corpus of 229 academic articles searching in the 89 Chartered Association of Business School (CABS) accounting journals ranked 1, 2, 3, 4, and 4* over a period of 22 years. A total of 32 academic articles were included in the core analysis showing a total number of 2418 citations. We identify three research streams, namely 1) sustainability accounting and accounting for renewable energy; 2) the relationship between accounting, institutions, and the environment; and 3) environmental accounting, management, and sustainable development. The main theoretical and practical implications of this paper's findings are that the role of accounting and auditing for renewable energy is a prominent research topic for academics, practitioners, decision-makers, and policy-makers to consider.
On a conjecture by Griggs, Kleitman and Shastri
(Korean Mathematical Society, 2025-05) Mafuta, Phillip; Mukwembi, Simon; Munyira, Sheunesu; Rodrigues, Bernardo Gabriel; bernardo.rodrigues@up.ac.za
Please read abstract in the article.
Maladaptive daydreaming should be included as a dissociative disorder in psychiatric manuals : position paper
(Cambridge University Press, 2025) Soffer-Dudek, Nirit; Somer, Eli; Spiegel, David; Chefetz, Richard; O'Neil, John; Dorahy, Martin J.; Cardena, Etzel; Mamah, Daniel; Schimmenti, Adriano; Musetti, Alessandro; Boon, Suzette; Van Dijke, Annemiek; Ross, Colin; Nijenhuis, Ellert; Krause-Utz, Annegret; Dell, Paul; Gold, Steven N.; Pietkiewicz, Igor; Silberg, Joyanna; Steele, Kathy; Moskowitz, Andrew; Draijer, Nel; Thomson, Paula; Barach, Peter; Kinsler, Philip; Maves, Peter; Sar, Vedat; Kruger, Christa; Middleton, Warwick
Maladaptive daydreaming is a distinct syndrome in which the main symptom is excessive vivid fantasising that causes clinically significant distress and functional impairment in academic, vocational and social domains. Unlike normal daydreaming, maladaptive daydreaming is persistent, compulsive and detrimental to one’s life. It involves detachment from reality in favour of intense emotional engagement with alternative realities and often includes specific features such as psychomotor stereotypies (e.g. pacing in circles, jumping or shaking one’s hands), mouthing dialogues, facial gestures or enacting fantasy events. Comorbidity is common, but existing disorders do not account for the phenomenology of the symptoms. Whereas non-specific therapy is ineffective, targeted treatment seems promising. Thus, we propose that maladaptive daydreaming be considered a formal syndrome in psychiatric taxonomies, positioned within the dissociative disorders category. Maladaptive daydreaming satisfactorily meets criteria for conceptualisation as a psychiatric syndrome, including reliable discrimination from other disorders and solid interrater agreement. It involves significant dissociative aspects, such as disconnection from perception, behaviour and sense of self, and has some commonalities with but is not subsumed under existing dissociative disorders. Formal recognition of maladaptive daydreaming as a dissociative disorder will encourage awareness of a growing problem and spur theoretical, research and clinical developments.
Textual dimensions of sustainability information, stock price informativeness, and proprietary costs : evidence from integrated reports
(Elsevier, 2025-05) Barth, Mary E.; Cahan, Steven F.; Chen, Li; Venter, Elmar Retief; Wang, Ruili; elmar.venter@up.ac.za
We examine whether integrated report quality, IRQ, is negatively associated with stock price synchronicity, an inverse measure of firm-specific information, and the extent to which the relation between IRQ and synchronicity is attenuated by proprietary costs. We measure IRQ using machine-based textual analysis along four dimensions: textual attributes, topical content, integrated reporting capitals, and financial versus sustainability information. We find that measures of IRQ based on seven textual attributes are negatively related to synchronicity, which is consistent with higher quality text containing more firm-specific content. Using PhraseLDA to identify topics in integrated reports, we find that contents related to the three most common categories—governance, performance, and risks and opportunities—are negatively associated with synchronicity. We find similar results for all integrated report capitals, except manufactured capital. Further, we find that sustainability information has a larger negative association with synchronicity than financial information. We also find that proprietary costs stemming from product market competition attenuate the association between IRQ and synchronicity, which suggests the informativeness of integrated reports varies with a firm's competitive environment. Our results may inform the International Sustainability Standards Board as it considers the role of the Integrated Reporting Framework in developing sustainability standards.
Insufficient collection capacity and facility, bane of plant taxonomic research in Nigeria
(Canadian Science Publishing, 2025-05) Ajao, Abdulwakeel Ayokun-nun; Akomolafe, Gbenga Festus; Olaniyan, Oluwayemisi Dorcas; Chukwuma, Emmanuel C.; Ugbogu, Alaba O.; Adeonipekun, Peter A.; Ayodele, Abiodun E.; Adeyemi, Sherif B.; Tiamiyu, Bashir Bolaji; Yaradua, Samaila Samaila; Saheed, Sefiu A.; Oladipo, Olaniran Temitope; Oyebanji, Oyetola
This article explores the pivotal role of herbaria in supporting taxonomic research in Nigeria and highlights the need to improve herbarium infrastructure to enhance plant diversity research in the country. Thirteen herbaria are currently recognized in Nigeria on the Index Herbariorum database and collectively house about 260 000 specimens. The Forest Herbarium Ibadan (FHI) is the largest, containing nearly 50% of these specimens. Based on the occurrence data of Nigerian plants on the Global Biodiversity Information Facility (GBIF), the herbaria, namely FHI, ABUH, LUH, NAUH, and UNICAL contributed only 29.9% compared to international herbaria (70.1%). This disparity underscores the need to strengthen the herbarium collection infrastructure in Nigeria. Taxonomic revisionary studies in Nigeria are very scarce as most of the studies have focused on the morpho-anatomical analysis of plant taxa. The poor taxonomic capacity in the country, which is due to insufficiency of collection capacity and trained taxonomists, has been a bane to the compilation of flora of Nigeria and the inability to document the conservation status of threatened plant species, as more than half (66.0%) of Nigeria’s plants published on GBIF have not been evaluated. There is an urgent need for capacity building for plant collection, curation, and taxonomic review.
Public transport systems and safety of female commuters in low-and-middle-income countries : a systematic scoping review
(BioMed Central, 2025-05) Mchunu, Gugu G.; Kuupiel, Desmond; Ncama, Busisiwe P.; Isike, Christopher; Kistan, Marcel; Pillay, Julian David; Duma, Sinegugu E.
BACKGROUND : This scoping review systematically maps and summarises research evidence concerning the safety of female commuters in public transport systems across Low- and Middle-Income Countries (LMICs). Given the essential role of public transport in LMICs, particularly for women in both formal and informal sectors, understanding the safety challenges they face is crucial. METHODS : We followed the Arksey and O’Malley methodological framework to structure this scoping review. The Population (Females), Concept (safety in public transport/transit), and Context (LMICs) framework guided our eligibility criteria. We searched for original research articles in PubMed, EBSCOhost (CINAHL, PsycInfo, and Health Source: Nursing/Academic Edition), SCOPUS, and Web of Science published between 2012 and 2023, and updated in February 2025. We additionally searched Google Scholar platform, and the reference list of included studies to uncover any additional relevant literature. The study selection and data extraction were performed by two reviewers using pilot-tested forms. Thematic analysis was used to organise the data into themes and a narrative summary of the findings is presented. RESULTS : Of the total 114 articles obtained from the database searches, 26 studies published in 14 countries met the inclusion criteria. The review identified a paucity of research in this area, with an average of three relevant papers published per year. The existing literature is geographically imbalanced, with a predominant focus on South Africa, India, and Malaysia, leaving many LMICs underrepresented. Most (11 out of 26) studies employed quantitative methods, leaving a need for more diverse research methodologies. Widespread concerns, fear of assault and harassment among women commuters across various countries; underreporting of sexual harassment, prevalence of violence against women in public transport systems with its psychological, economic, health, and social consequences; and transit sexual assault were among the themes identified. CONCLUSION : This scoping review reveals the urgent need for further research on the safety of female commuters in LMICs, especially in underrepresented countries, to provide a more comprehensive understanding of the challenges faced by women in diverse contexts. It advocates for diversified research methods, public awareness campaigns, improved reporting mechanisms, policy reforms, infrastructure enhancements, and culturally sensitive initiatives to ensure the safety and well-being of female commuters in public transport systems across LMICs.
Enhancing HIV self-testing uptake among university students in Rwanda : the proportion, barriers, and opportunities
(BioMed Central, 2025-03) Mukashyaka, Ritah; Kaberuka, Gerald; Favina, Alain; Lutasingwa, Dan; Mulisa, Fred; Turatsinze, Everest; Karanja, Ann; Kansiime, Deborah; Niyotwagira, Egide; Ikuzo, Basile; Kaggwa, Mark Mohan; Kagaba, Aflodis; Mathebula, Evans Mantiri; Rwibasira, Gallican N.
INTRODUCTION : University students in Rwanda are at high risk for HIV, yet they have a low uptake of HIV self-testing, which is crucial for HIV diagnosis and prevention. This study investigated their knowledge, behaviors, and perceptions towards HIV self-testing, highlighting the barriers and opportunities whose consideration is necessary for the improvement of HIV self-testing uptake in this population. METHOD : A concurrent mixed-method design was used, and it involved 424 students from five universities across Rwanda. Quantitative data was collected through surveys, and descriptive statistics were performed. Chi-square tests were performed, and sociodemographic variables were stratified against the awareness of HIV self-testing and HIV self-testing for the past 12 months variables. Qualitative data was collected through in-depth interviews and focus group discussions using interview guides developed based on the Health Belief Model (HBM) framework; data was then analyzed thematically. RESULTS : The mean age was 23 (IQR: 21; 24), with 51.2% (n = 214/424) females. 64.7% (n = 261/424) of students had never heard of HIV self-testing, yet 37.74% (160/424) were sexually active. Among sexually active students, 17.87% were aware of HIV self-testing, but 35.82% had never used it. The reported perceived HIV self-testing barriers include high cost, unavailability of testing kits, lack of awareness, misinformation, and absence of post-test counseling. However, some HIV self-testing opportunities, like the availability of testing kits and motivating factors for university students to test, were also reported. CONCLUSION : Although university students reported the needs and benefits of HIV self-testing, uptake remains low due to misinformation, unawareness, unavailability, and the high cost of HIV self-testing kits. Increasing awareness, availing HIVST kits, and addressing the other reported barriers to HIV self-testing, is essential for the achievement of the universal goal of HIV status awareness among university students.
Dizziness and imbalance and their association with general and mental health in a community-based cross-sectional study of middle-aged individuals : the Busselton healthy ageing study
(BioMed Central, 2025-04) Smit, Adriana L.; Eikelboom, Robert H.; Bucks, Romola S.; Atlas, Marcus D.; Hunter, Michael; Stegeman, Inge
BACKGROUND : Dizziness and imbalance are common symptoms among patients visiting healthcare providers. Current knowledge about their prevalence, impact on daily life, and associated factors is primarily based on selected samples from individuals seeking medical help, particularly older individuals. This study aimed to estimate the prevalence, symptoms, and impact of dizziness or imbalance symptoms, and to assess the association between these symptoms and their characteristics with demographic, general health, and mental health factors in middle-aged men and women from a representative, general population sample. METHODS : Cross-sectional data were collected from participants aged 45 to 70 years in the Busselton Healthy Ageing Study (BHAS), recruited in the City of Busselton, Western Australia. The data included physical tests and health-related questionnaires covering demographics, medical history, general and mental health, including any dizziness and imbalance symptoms and their impact on daily life. Estimates were made of the prevalence, patterns, and impact of dizziness and imbalance symptoms. Logistic regression was employed to calculate the association between demographic, mental and general health (independent variables) and the presence of dizziness or imbalance symptoms (dependent variable). Adjustments were made for sex and age as confounding factors. RESULTS : Of the 5086 participants, 1216 (23.9%) reported imbalance or dizziness, with light-headedness the most common type (64.3%; 782 of 1216). For nearly half (565; 46.5%) the imbalance or dizziness occasionally effected daily life, while for some, the impact was frequent (n = 50, 4.1%) or constant (n = 15, 1.2%). Being female (adjusted OR 2.05, 95%CI 1.79-2.34) and older in age (in years; adjusted OR 1.02, 95%CI 1.00-1.03), having a history of general health issues, and experiencing mental health problems or mental health symptoms were significantly associated with dizziness or imbalance symptoms. CONCLUSIONS : Dizziness or imbalance are common symptoms among individuals aged 45 to 70 years and are associated with older age, being female, and poorer general and mental health. Given that approximately half of those affected reported occasional effects on daily life, with a few reporting frequent or constant effects, the outcomes of the study could help to raise awareness among healthcare providers about the prevalence, symptoms, and associated conditions.

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