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Psychometric validation of the community antimicrobial use scale (CAMUS) in primary healthcare and the implications for future use
Ramdas, Nishana; Schellack, Natalie; Uys, Corrie; Godman, Brian; Campbell, Stephen M.; Meyer, Johanna C. (MDPI, 2026-01)
BACKGROUND/OBJECTIVES : Patient-level factors strongly influence antimicrobial resistance (AMR) through the pressure applied to healthcare professionals to prescribe antibiotics even for self-limiting viral infections, enhanced by knowledge and attitude concerns. This includes Africa, with high levels of AMR. However, validated measurement tools for African primary healthcare (PHC) are scarce. This study evaluated the reliability, structural validity, and interpretability of the Community Antimicrobial Use Scale (CAMUS) in South Africa. METHODS : A cross-sectional survey was conducted with 1283 adults across 25 diverse public PHC facilities across two provinces. The 30-item theory-based tool underwent exploratory and confirmatory factor analysis (EFA/CFA), reliability, and validity testing. RESULTS : EFA identified a coherent five-factor structure: (F1) Understanding antibiotics; (F2) Social and behavioural norms; (F3) Non-prescribed use; (F4) Understanding of AMR; and (F5) Attitudes. Internal consistency was strongest for knowledge and misuse domains (alpha approximation 0.80). Test–retest reliability was good-to-excellent (ICC: 0.72–0.89). CFA confirmed acceptable composite reliability (CR ≥ 0.63). Although average variance extracted (AVE) was low for broader behavioural constructs, indicating conceptual breadth, it was high for AMR knowledge (0.737). Construct validity was supported by positive correlations with health literacy (r = 0.48) and appropriate use intentions (r = 0.42). Measurement error metrics (SEM = 1.59; SDC = 4.40) indicated good precision for group-level comparisons. CONCLUSIONS : CAMUS demonstrated a theoretically grounded structure with robust performance in knowledge and misuse domains. While social and attitudinal domains require refinement, we believe the tool is psychometrically suitable for group-level antimicrobial use surveillance and programme evaluation in South African PHC settings and wider to help with targeting future educational programmes among patients.
Behavior and functional ecology of the African termite-raiding ant
Yusuf, Abdullahi Ahmed (Annual Reviews, 2026-01)
Ants and termites play important roles in tropical ecosystems, leading to an evolutionary arms race in which diverse foraging, predation, and counterpredation strategies developed. These strategies resulted in the emergence of specialized predators of termites, such as the African termite-raiding ant, Megaponera analis, which organizes coordinated raids on termites of agricultural importance belonging to the subfamily Macrotermitinae. Decades of field and laboratory studies have examined the natural history of M. analis, describing its distribution, raiding behavior, chemical ecology, task allocation, rescue and other helping behaviors, and nursing of wounds. However, the potential of M. analis for the management of termites is yet to be explored. This review synthesizes the literature on M. analis, outlines recent progress in understanding its ecology, identifies knowledge gaps, and proposes directions for future research and possible applications of the knowledge to different fields.
Temperature-related health impacts : a scoping review and benchmarking exercise to inform a heat action plan
Wright, Caradee Yael; Bulani, Muthise; Kapwata, Thandi; Dikoko, Viwe; Naidoo, Natasha (Ubiquity Press, 2026-01)
BACKGROUND : Global heating is associated with adverse health impacts necessitating the implementation of Heat Action Plans (HAPs) to protect communities. Gauteng in South Africa is the most populated province, housing three cities (i.e., Johannesburg, Ekurhuleni, and Pretoria) and 25% of the national population. OBJECTIVE : Given rising temperatures and projected increases in heatwaves and hot days, we gathered literature and case studies to inform the development of a Gauteng HAP. METHODS : We conducted a scoping review to inform baseline data on heat‑related health impacts for Gauteng and South Africa too, followed by a benchmarking exercise that aimed to identify international best practices that may inform Gauteng’s plan. Benchmarking was done using Maharashtra (India), Victoria (Australia), and Khyber Pakhtunkhwa (Pakistan). FINDINGS : Thirty‑six studies were included in the review, with 13 including Gauteng data and all showing impacts of heat on human health. Most studies applied epidemiological time series linking meteorological exposure (temperature/heat indices) and/or air pollutants (e.g., PM2.5, PM10, NO2, and O3) with health outcomes; applied remote‑sensing, reanalysis, or station data for exposure assessment; and used regression or distributed lag models. The benchmarking exercise identified exemplars’ distinctive strengths: Victoria’s district thresholds keep activation simple and local—ideal for Gauteng’s heterogeneous microclimates across metros and townships. Maharashtra’s graded activation and clear departmental roles reduce ambiguity during multi‑day heatwaves and thereby would help to align Gauteng Health, Infrastructure, Social Development departments. Khyber Pakhtunkhwa’s cooling‑camp model shows practical, low‑cost interventions of a low‑ and middle‑income country that can be replicated at taxi ranks/clinics/malls during temperature peaks. CONCLUSIONS : Insights from the literature and international exemplars provide a strong evidence base and adaptable models to guide a context‑specific, multi‑sectoral HAP for Gauteng that enhances preparedness, coordination, and community protection in a warming South Africa.
Human tissue research ethics and consent models : global reflections in anatomical sciences
Singh, S.; De Gama, Brenda Zola; Pillay, P. (Elsevier, 2026-02)
BACKGROUND : Human tissue research has evolved to include three-dimensional (3-D) printing, genetic research, digital imaging of human tissue, plastination, and the public display of human tissue. This has resulted in several concerns about ethical acquisition, storage, and use of human tissue, particularly informed consent. This empirical study obtained the perspectives and viewpoints of anatomists and researchers across five countries on the ethical components of human tissue research. METHODS : Thirty in-depth Zoom interviews were conducted with participants from South Africa, the United States of America (USA), New Zealand, Germany, and France. Participants shared their perspectives and viewpoints on informed consent models, ethical challenges surrounding human tissue research, and existing gaps in policy guidelines. The data was analysed using thematic and content analysis. RESULTS : Participants (57 %) indicated that human tissue research on the living and deceased is ethically different; hence, requires separate policy guidelines and regulations. There was a clear preference for ‘broad consent’ and ‘fully informed consent’ when conducting research on living humans and using cadaveric tissue, respectively. Key ethical challenges and policy gaps were identified as contemporary human tissue research, commercialising human tissue, consent for foetal tissue, and using unconsented skeletal collections and unidentified bodies for human tissue research. CONCLUSIONS : This study highlights the moral complexity of contemporary human tissue research. It underscores the necessity for context-specific consent models and regulatory alignment for commercialisation and contemporary research uses of human tissue. Additionally, recommendations are provided to fill the policy gaps highlighted on consent models and ethical challenges in human tissue research.
Euthanasia methods in invertebrates : a critical narrative review of methodological and welfare standards
Bakker, Jaco; De la Garza, Melissa A.; Morel, Margot; Outwater, Anne H.; Chipangura, John Kudakwashe; Stumpel, Job B.G.; Vercammen, Francis; Lewbart, Gregory A.; Nederlof, Remco A. (MDPI, 2026-01)
Invertebrates are increasingly consumed and kept as pets, research models, and in zoological exhibits, creating a growing need to better understand their clinical management and welfare. However, the knowledge regarding nociception, pain perception, and euthanasia in invertebrates remains limited, and standardized protocols are largely absent. Current guidelines are incomplete, often anecdotal, and omit several major invertebrate phyla. To address this gap, we conducted a narrative review of the literature, aiming to critically evaluate existing euthanasia methods, associated welfare implications, and opportunities for refinement. The amount of peer-reviewed species-specific literature is limited and scattered. In addition, most described methods are insufficiently studied and/or do not align with our definition of euthanasia. Based on the available literature, and to provide practical guidance despite these limitations, we propose a two-step approach to invertebrate euthanasia. The first step consists of inducing anesthesia to achieve loss of responsiveness, followed by a second step; a terminal procedure involving physical or chemical destruction of the brain or major ganglia. Our review focuses on the application of this two-step approach. The effectiveness and humaneness of euthanasia techniques vary considerably across taxa and life stages. Substantial further research is required to validate and optimize humane end-of-life procedures for diverse invertebrate species. SIMPLE SUMMARY Euthanasia is an inevitability in the veterinary profession. The method of euthanasia used must rapidly induce loss of consciousness and death, be effective, and minimize the pain, fear, and distress experienced by the animal. Interference with euthanasia objectives, e.g., research, should be avoided if possible. Moreover, the method of euthanasia should be simple enough to be performed effectively by competent individuals. The availability of peer-reviewed literature specific to invertebrates is scattered and limited. Based on the available scientific evidence, the most effective methods of invertebrate euthanasia entail a two-step approach. Here, the first step consists of the induction of anesthesia to achieve loss of responsiveness, followed by a terminal second step, involving physical or chemical destruction of the brain or major ganglia. The effectiveness and perceived humaneness of euthanasia techniques vary considerably across taxa and life stages.