Type I Diabetes Mellitus (T1DM) is a major health problem and a burden for affected young individuals, as well as for society. It is among the most prevalent paediatric disorders, affecting an estimated 1.7 per 100 children and adolescents. Given the complexity of diabetes treatment regimens, it is not surprising that children, adolescents, and their families often have difficulty adhering to these regimens. Studies have found that the overall adherence rate among children and adolescents with diabetes is about 50%. It has also been found that adherence to T1DM often tends to decrease when the adolescent begins to assume most of the responsibility for managing the disease and the parents‟ role starts to decline. However, literature indicates that adolescent patients‟ adherence is poor and an important strategy to improving their metabolic control is to increase self-care. The most common age of onset for T1DM is between 10-14 years. The adolescent population is highly neglected in current research on diabetes, because the focus tends to favour children and not adolescents. It is widely recognised that glycaemic control in adolescents is complex, challenging and dependent on interconnected relationships between numerous inputs at individual, family, community and health service levels. Optimal care of adolescents with diabetes has not been subjected to rigorous scientific studies, and research results related to optimal glycaemic control are conflicting. Development and continuous evaluation of best practices pertaining to diabetes mellitus remains one of the major objectives of diabetes care, possibly allowing a delay in and/or prevention of later complications. Research indicates that adolescence is the one age group where there has been no discernible improvement in health over the last 20 years. A great number of research studies on the subject of diabetes are done globally, but less literature, especially in the South African context, can be found that focuses on and explain the experiences of adolescents with T1DM with regard to their treatment adherence. This qualitative study explored the experiences of adolescents with T1DM. A purposive sample (n=7) of young adolescents between the ages of 13 and 15 willingly participated in the research study to explore and describe their experiences with managing their treatment regimen. In-depth interviews were conducted to collect rich descriptive data, followed by participants‟ verbal reflections once a week for the duration of a month. After the in-depth interviews and weekly reflections, the researcher held a focus group interview with all the participants. Transcribed data were analysed by means of thematic analysis from which themes and subthemes were derived. The participants expressed both positive and negative emotions associated with their diabetes; they experienced a lack of understanding by significant others because of a lack of knowledge, interest or support regarding their diabetes; they mentioned that they continually need age-appropriate support and parental involvement, even though they manage diabetes through their own processes; and lastly, participants struggled with a fear of friends‟ and peers‟ perceptions. From the findings it is clear that in order to cope, the adolescents need not only medical treatment and education about diabetes (T1DM), but emotional support, supervision and repeated reinforcement to achieve effective self-management. The basic suggestion is that diabetes care for children and young people should include routine assessment of the psychological and social pressures on the adolescent and the family so that strategies can be put in place to give support and education as needed and as appropriate. The researcher also recommends that school personnel must be educated about diabetes so that they can understand the changing medical and psychosocial needs of the adolescent and can help him/her to participate fully in all the available work, sport, and leisure activities. Models of legislation and training programmes for school staff specifically addressing the needs of children with diabetes in school have been developed in a number of countries such as Greece, Germany, Italy, Poland, Spain, Sweden, the UK and the USA. These programmes should be considered as an example to other countries. These best practices can serve as a foundation for national improvement. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

Type I Diabetes Mellitus (T1DM) is a major health problem and a burden for affected young individuals, as well as for society. It is among the most prevalent paediatric disorders, affecting an estimated 1.7 per 100 children and adolescents. Given the complexity of diabetes treatment regimens, it is not surprising that children, adolescents, and their families often have difficulty adhering to these regimens. Studies have found that the overall adherence rate among children and adolescents with diabetes is about 50%. It has also been found that adherence to T1DM often tends to decrease when the adolescent begins to assume most of the responsibility for managing the disease and the parents‟ role starts to decline. However, literature indicates that adolescent patients‟ adherence is poor and an important strategy to improving their metabolic control is to increase self-care. The most common age of onset for T1DM is between 10-14 years. The adolescent population is highly neglected in current research on diabetes, because the focus tends to favour children and not adolescents. It is widely recognised that glycaemic control in adolescents is complex, challenging and dependent on interconnected relationships between numerous inputs at individual, family, community and health service levels. Optimal care of adolescents with diabetes has not been subjected to rigorous scientific studies, and research results related to optimal glycaemic control are conflicting. Development and continuous evaluation of best practices pertaining to diabetes mellitus remains one of the major objectives of diabetes care, possibly allowing a delay in and/or prevention of later complications. Research indicates that adolescence is the one age group where there has been no discernible improvement in health over the last 20 years. A great number of research studies on the subject of diabetes are done globally, but less literature, especially in the South African context, can be found that focuses on and explain the experiences of adolescents with T1DM with regard to their treatment adherence. This qualitative study explored the experiences of adolescents with T1DM. A purposive sample (n=7) of young adolescents between the ages of 13 and 15 willingly participated in the research study to explore and describe their experiences with managing their treatment regimen. In-depth interviews were conducted to collect rich descriptive data, followed by participants‟ verbal reflections once a week for the duration of a month. After the in-depth interviews and weekly reflections, the researcher held a focus group interview with all the participants. Transcribed data were analysed by means of thematic analysis from which themes and subthemes were derived. The participants expressed both positive and negative emotions associated with their diabetes; they experienced a lack of understanding by significant others because of a lack of knowledge, interest or support regarding their diabetes; they mentioned that they continually need age-appropriate support and parental involvement, even though they manage diabetes through their own processes; and lastly, participants struggled with a fear of friends‟ and peers‟ perceptions. From the findings it is clear that in order to cope, the adolescents need not only medical treatment and education about diabetes (T1DM), but emotional support, supervision and repeated reinforcement to achieve effective self-management. The basic suggestion is that diabetes care for children and young people should include routine assessment of the psychological and social pressures on the adolescent and the family so that strategies can be put in place to give support and education as needed and as appropriate. The researcher also recommends that school personnel must be educated about diabetes so that they can understand the changing medical and psychosocial needs of the adolescent and can help him/her to participate fully in all the available work, sport, and leisure activities. Models of legislation and training programmes for school staff specifically addressing the needs of children with diabetes in school have been developed in a number of countries such as Greece, Germany, Italy, Poland, Spain, Sweden, the UK and the USA. These programmes should be considered as an example to other countries. These best practices can serve as a foundation for national improvement. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

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Yes / We investigated whether companion drug resistance was associated with adverse outcome of the shorter MDR-TB regimen in Bangladesh, after adjusting for fluoroquinolone resistance. MDR/RR-TB patients registered for treatment with a standardized gatifloxacin-based shorter MDR-TB regimen were selected for the study. Drug resistance was determined using the proportion method, gatifloxacin and isoniazid minimum inhibitory concentration testing for selected isolates, and whole genome sequencing. Low-level and high-level fluoroquinolone resistance were the most important predictors of adverse outcomes, with pyrazinamide resistance having a significant yet lower impact. In patients with fluoroquinolone-/second-line injectable-susceptible TB, non-eligibility to the shorter MDR-TB regimen (initial resistance to either pyrazinamide, ethionamide, or ethambutol) was not associated with adverse outcome (aOR 1.01; 95%CI 0.4-2.8). Kanamycin resistance was uncommon (1.3%). Increasing levels of resistance to isoniazid predicted treatment failure, also in a subgroup of patients with high-level fluoroquinolone-resistant TB. Our results suggest that resistance to companion drugs of the shorter MDR-TB regimen, except kanamycin resistance, is of no clinical importance as long as fluoroquinolone susceptibility is preserved. Hence, contrary to current WHO guidelines, exclusions to the standard regimen are justified only in the case of fluoroquinolone, and possibly kanamycin resistance. / Damien Foundation Belgium for its financial and logistic support to run the project including its research activities. European Research Council (Starting Grant INTERRUPTB 311725).

Diabetes mellitus is a chronic disease affecting millions of people worldwide. The degenerative changes caused by diabetes can, however, be controlled through the correct treatment. The outcome of diabetes mellitus depends mainly on the patient's self-management. Health professionals therefore have a major responsibility to assist patients to acquire the essential knowledge, skills and attitudes for self-management. The purpose of this study was to identify diabetic patients and family members' knowledge and views about diabetes mellitus and its treatment regimen. A quantitative descriptive survey design was used. Questionnaires were used to collect data from a convenient sample of diabetic patients and family members. Data was analysed by a computer program called Statistical Package for Social Sciences. Findings revealed that patients and family members lack adequate knowledge on diabetes mellitus and its treatment. Recommendations regarding the required information and assistance to be given to diabetic patients and their family members were formulated. / Health Studies / (MA (Health Studies))

Diabetes mellitus is a chronic disease affecting millions of people worldwide. The degenerative changes caused by diabetes can, however, be controlled through the correct treatment. The outcome of diabetes mellitus depends mainly on the patient's self-management. Health professionals therefore have a major responsibility to assist patients to acquire the essential knowledge, skills and attitudes for self-management. The purpose of this study was to identify diabetic patients and family members' knowledge and views about diabetes mellitus and its treatment regimen. A quantitative descriptive survey design was used. Questionnaires were used to collect data from a convenient sample of diabetic patients and family members. Data was analysed by a computer program called Statistical Package for Social Sciences. Findings revealed that patients and family members lack adequate knowledge on diabetes mellitus and its treatment. Recommendations regarding the required information and assistance to be given to diabetic patients and their family members were formulated. / Health Studies / (MA (Health Studies))