Genetic characteristics of Human Immunodeficiency Virus-1, and deter-minants of late presentation for care and Diabetes mellitus amongst newly diagnosed Human Immunodeficiency Virus positive patients in the Eastern Cape, South Africa.
- Authors: Sogbanmu, Olufunso Oladipo
- Date: 2019
- Subjects: HIV infections
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/${Handle} , vital:40495
- Description: Phylogenies may help to characterize transmission pairs, enhance contact tracing and outbreak investigations, track the origin and spread of epidemics over place and time, and to identify patterns of onward Human Immunodeficiency-Virus (HIV) transmission among risk groups. If the pattern and evolution of HIV drug resistance can be mapped, this may influence the development of guidelines in the clinical management of HIV especially with issues relating to prevalence of primary drug resistance and its impact on outcomes of present antiretroviral treatment (ART) regimen in use and the ability to trace and track the development of drug resistant strains. The roll-out of the test and treat Programme for newly diagnosed HIV infected pa-tient, seeks to identify HIV infected individuals early and to prevent morbidity and mortality associated with the late presentation for HIV care. The determination of the magnitude of ‘late presentation’ and or ‘presentation with advanced HIV disease’ can be used in very diverse settings and for many purposes. It provides a unified way to define the problem, thereby targeting appropriate interventions to prevent the detrimental outcomes associated with late presentation to care. The subtle relationship between HIV and diabetes mellitus (DM) may also help in formulating better preventive programs to aid the control of non-communicable diseases such as DM. This cross-sectional study includes a purposive selection of 335 HIV positive patients attending the voluntary counselling and Testing (VCT) and HIV Counselling and Testing (HCT) centres and outpatient departments at Cecilia Makiwane Hospital and the HCT sites at the Buffalo District municipality community health centres, Eastern Cape Province, South Africa. Late or delayed presentation of HIV infection was defined as CD4 cell count beneath 350 cells/μL and/or patients presenting with an AIDS-defining event at the first follow-up regardless of the CD4 cell count. Chapter 1 provides the general introduction had an overview of the introduction to the study, the statement of the research problem, hypothesis, the aim and the objectives. xx Chapter 2 looked in-depth at the HIV, case definition, the latest epidemiology of HIV, the HIV genome, the life cycle of HIV, its diagnosis, the classes of antiretroviral drugs, development of drug resistance. Chapter 3 highlighted the prevalence of Transmitted Drug Resistance (TDR) with focus on the protease gene. RNA was extracted from blood samples of 72 newly diagnosed HIV-1 patients attending some HIV testing and counselling clinics from August 2016 to July 2017. Protease fragments were amplified with specific primers by RT-PCR followed by nested PCR. The amplified products were sequenced using the ABI 360 sequencer, edited with Geneious version 9.1.5 and translated into amino acid with BioEdit software. Drug related resistance mutation (DRMs) analysis was performed on all the protease sequences in accordance with the 2009 WHO list of surveillance drug resistance mutations by submitting the edited sequences to Stanford HIV drug interpretation programme and the international AIDS society-USA guidelines for query of drug resistance associated mutations while phylogenetic analysis was performed using MEGA 6 to allocate all viral sequences into subtypes. In the study, a total of 52/72 (71.1%) reliable HIV-1 protease sequences were obtained in which subtyping and drug resistance mutations were performed. Two (3.8%) major Protease resistance associated mutation (V82A/L and L90M) were observed while another polymorphism like L10F, T74S, Q58E, L10I/V and M46V were also identified. Phylogenetic analyses delineated all the sequences as HIV-1 subtype C. Chapter 4 describes the prevalence and the determinants of late presentation amongst newly diagnosed HIV positive individuals in the Eastern Cape. It indicates the extent of the prevalence of patients presenting to care and at what HIV stage they were assessing health care services since the inception of the ‘test and treat’ strategy. It is a cross-sectional study where a total of 335 newly diagnosed patients were recruited consecutively be-tween August 2016 and July 2017. Late presenter for HIV care was defined in accordance with the European Late Presenter Consensus working group as a patient who reports for care when the CD4 count is below 350 cells/μL and/or when there is an established Aids- xxi defining clinical condition, irrespective of CD4 count. Adjusted and unadjusted logistic regression analysis was used to examine the determinants of late HIV diagnosis. The study showed that 60% of patients were late presenters, with 35% presenting with advanced disease. The major determinants identified were being male and low level of education. This led to recommendations directed at ensuring programmes that targets men in identifying their HIV status and assess care at early stage to prevents the morbidity and mortality associated with delayed presentation. Also, it was recommended that effort should be made to improve access to education and also include HIV related topics into the educational curriculum. Chapter 5 aimed to describe the prevalence and determinants of DM amongst newly diagnosed HIV positive individuals. This is a cross-sectional study which recruited 335 patients between August 2016 and September 2017. Definition for diabetes mellitus was made based on the SEDMSA 2015 guideline of HBA1C of above 6.5%. Adjusted and unadjusted logistic regression analysis was used to examine the determinants of abnormal glycated haemoglobin. Findings showed the prevalence of DM at about 6% amongst newly diagnosed HIV positive individuals. This is similar to findings in other study within the country, but a bit lower than what was obtained in the developed countries. The role of older age (above 40 years) as predisposing factor to development of diabetes in newly diagnosed HIV positive individual was well noted and taken. This ensures that screening for DM should be targeted at elderly HIV positive individuals. The grey area of the appropriate mode of diagnostic test to use to diagnose HIV is still debatable, however, a combination of HBA1c and fasting blood sugar (FBS) may improve the diagnosis of DM in this population group. In chapter 6, the general conclusions, recommendations and future perspectives of the study are reflected.
- Full Text:
- Authors: Sogbanmu, Olufunso Oladipo
- Date: 2019
- Subjects: HIV infections
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/${Handle} , vital:40495
- Description: Phylogenies may help to characterize transmission pairs, enhance contact tracing and outbreak investigations, track the origin and spread of epidemics over place and time, and to identify patterns of onward Human Immunodeficiency-Virus (HIV) transmission among risk groups. If the pattern and evolution of HIV drug resistance can be mapped, this may influence the development of guidelines in the clinical management of HIV especially with issues relating to prevalence of primary drug resistance and its impact on outcomes of present antiretroviral treatment (ART) regimen in use and the ability to trace and track the development of drug resistant strains. The roll-out of the test and treat Programme for newly diagnosed HIV infected pa-tient, seeks to identify HIV infected individuals early and to prevent morbidity and mortality associated with the late presentation for HIV care. The determination of the magnitude of ‘late presentation’ and or ‘presentation with advanced HIV disease’ can be used in very diverse settings and for many purposes. It provides a unified way to define the problem, thereby targeting appropriate interventions to prevent the detrimental outcomes associated with late presentation to care. The subtle relationship between HIV and diabetes mellitus (DM) may also help in formulating better preventive programs to aid the control of non-communicable diseases such as DM. This cross-sectional study includes a purposive selection of 335 HIV positive patients attending the voluntary counselling and Testing (VCT) and HIV Counselling and Testing (HCT) centres and outpatient departments at Cecilia Makiwane Hospital and the HCT sites at the Buffalo District municipality community health centres, Eastern Cape Province, South Africa. Late or delayed presentation of HIV infection was defined as CD4 cell count beneath 350 cells/μL and/or patients presenting with an AIDS-defining event at the first follow-up regardless of the CD4 cell count. Chapter 1 provides the general introduction had an overview of the introduction to the study, the statement of the research problem, hypothesis, the aim and the objectives. xx Chapter 2 looked in-depth at the HIV, case definition, the latest epidemiology of HIV, the HIV genome, the life cycle of HIV, its diagnosis, the classes of antiretroviral drugs, development of drug resistance. Chapter 3 highlighted the prevalence of Transmitted Drug Resistance (TDR) with focus on the protease gene. RNA was extracted from blood samples of 72 newly diagnosed HIV-1 patients attending some HIV testing and counselling clinics from August 2016 to July 2017. Protease fragments were amplified with specific primers by RT-PCR followed by nested PCR. The amplified products were sequenced using the ABI 360 sequencer, edited with Geneious version 9.1.5 and translated into amino acid with BioEdit software. Drug related resistance mutation (DRMs) analysis was performed on all the protease sequences in accordance with the 2009 WHO list of surveillance drug resistance mutations by submitting the edited sequences to Stanford HIV drug interpretation programme and the international AIDS society-USA guidelines for query of drug resistance associated mutations while phylogenetic analysis was performed using MEGA 6 to allocate all viral sequences into subtypes. In the study, a total of 52/72 (71.1%) reliable HIV-1 protease sequences were obtained in which subtyping and drug resistance mutations were performed. Two (3.8%) major Protease resistance associated mutation (V82A/L and L90M) were observed while another polymorphism like L10F, T74S, Q58E, L10I/V and M46V were also identified. Phylogenetic analyses delineated all the sequences as HIV-1 subtype C. Chapter 4 describes the prevalence and the determinants of late presentation amongst newly diagnosed HIV positive individuals in the Eastern Cape. It indicates the extent of the prevalence of patients presenting to care and at what HIV stage they were assessing health care services since the inception of the ‘test and treat’ strategy. It is a cross-sectional study where a total of 335 newly diagnosed patients were recruited consecutively be-tween August 2016 and July 2017. Late presenter for HIV care was defined in accordance with the European Late Presenter Consensus working group as a patient who reports for care when the CD4 count is below 350 cells/μL and/or when there is an established Aids- xxi defining clinical condition, irrespective of CD4 count. Adjusted and unadjusted logistic regression analysis was used to examine the determinants of late HIV diagnosis. The study showed that 60% of patients were late presenters, with 35% presenting with advanced disease. The major determinants identified were being male and low level of education. This led to recommendations directed at ensuring programmes that targets men in identifying their HIV status and assess care at early stage to prevents the morbidity and mortality associated with delayed presentation. Also, it was recommended that effort should be made to improve access to education and also include HIV related topics into the educational curriculum. Chapter 5 aimed to describe the prevalence and determinants of DM amongst newly diagnosed HIV positive individuals. This is a cross-sectional study which recruited 335 patients between August 2016 and September 2017. Definition for diabetes mellitus was made based on the SEDMSA 2015 guideline of HBA1C of above 6.5%. Adjusted and unadjusted logistic regression analysis was used to examine the determinants of abnormal glycated haemoglobin. Findings showed the prevalence of DM at about 6% amongst newly diagnosed HIV positive individuals. This is similar to findings in other study within the country, but a bit lower than what was obtained in the developed countries. The role of older age (above 40 years) as predisposing factor to development of diabetes in newly diagnosed HIV positive individual was well noted and taken. This ensures that screening for DM should be targeted at elderly HIV positive individuals. The grey area of the appropriate mode of diagnostic test to use to diagnose HIV is still debatable, however, a combination of HBA1c and fasting blood sugar (FBS) may improve the diagnosis of DM in this population group. In chapter 6, the general conclusions, recommendations and future perspectives of the study are reflected.
- Full Text:
Teachers and learners’ perspectives towards English as a language of learning and teaching : a case of two selected secondary schools in the Amathole West Education District
- Osunkunle, Atinuke Oluwatoyin
- Authors: Osunkunle, Atinuke Oluwatoyin
- Date: 2019
- Subjects: English language -- Study and teaching Second language acquisition
- Language: English
- Type: Thesis , Masters , MEd
- Identifier: http://hdl.handle.net/10353/16243 , vital:40702
- Description: The study aimed at examining teachers and learners’ perspectives towards English as a language of learning and teaching (LoLT), using two selected secondary schools in the Amathole West Education District as a case study and to see if English is indeed a language of choice among learners and teachers. The researcher employed an interpretative qualitative research paradigm and purposive non-probability sampling method was used to draw samples of participants for in-depth interviews and focus group discussions. The school principal and two teachers were purposively selected in each of the two schools, making a total of two school principals and four teachers that were interviewed. In addition, a member of the School Governing Body (SGB) was selected in each of the two schools and interviewed. The study also had one focus group discussion with learners in each of the two selected schools, making two focus groups in total. All the one-on-one in-depth interviews as well as the focus group discussions with the learners were recorded and then transcribed. The collected data was later analysed thematically to infer the meaning and present the findings. The findings revealed that most of the students in public schools are torn between two divides as they struggle with the use of English as a language of learning and teaching but seem to have no choice, as they all believed that the use of English is quite beneficial to them in many ways. Another critical finding is that some teachers find it difficult to teach in English because they do not have a good command of the language. This makes them to code-switch regularly using IsiXhosa along with English while they are supposed to teach in English. Thus, this affects the learners proper understanding of and grounding in the English language. The study also found out that the schools lack adequate support to ensure the effective use of English for learning and teaching. The study recommended that various support systems from the government are needed in order to ensure the acceptance and successful use of English as LoLT in South African public schools. In this regard, the participants assured that these would result in positive outcomes, as they would provide quality education through government support. The study concluded that English is the preferred LoLT by both teachers and learners, thus, it needs to be prioritised.
- Full Text:
- Authors: Osunkunle, Atinuke Oluwatoyin
- Date: 2019
- Subjects: English language -- Study and teaching Second language acquisition
- Language: English
- Type: Thesis , Masters , MEd
- Identifier: http://hdl.handle.net/10353/16243 , vital:40702
- Description: The study aimed at examining teachers and learners’ perspectives towards English as a language of learning and teaching (LoLT), using two selected secondary schools in the Amathole West Education District as a case study and to see if English is indeed a language of choice among learners and teachers. The researcher employed an interpretative qualitative research paradigm and purposive non-probability sampling method was used to draw samples of participants for in-depth interviews and focus group discussions. The school principal and two teachers were purposively selected in each of the two schools, making a total of two school principals and four teachers that were interviewed. In addition, a member of the School Governing Body (SGB) was selected in each of the two schools and interviewed. The study also had one focus group discussion with learners in each of the two selected schools, making two focus groups in total. All the one-on-one in-depth interviews as well as the focus group discussions with the learners were recorded and then transcribed. The collected data was later analysed thematically to infer the meaning and present the findings. The findings revealed that most of the students in public schools are torn between two divides as they struggle with the use of English as a language of learning and teaching but seem to have no choice, as they all believed that the use of English is quite beneficial to them in many ways. Another critical finding is that some teachers find it difficult to teach in English because they do not have a good command of the language. This makes them to code-switch regularly using IsiXhosa along with English while they are supposed to teach in English. Thus, this affects the learners proper understanding of and grounding in the English language. The study also found out that the schools lack adequate support to ensure the effective use of English for learning and teaching. The study recommended that various support systems from the government are needed in order to ensure the acceptance and successful use of English as LoLT in South African public schools. In this regard, the participants assured that these would result in positive outcomes, as they would provide quality education through government support. The study concluded that English is the preferred LoLT by both teachers and learners, thus, it needs to be prioritised.
- Full Text:
An investigation of experiences encountered by female adults living with HIV/AIDS and taking ARV treatment: the case of Ntselanzi location, Raymond Mhlaba municipality, Alice Eastern Cape
- Authors: Matumelo, Nobuhle
- Date: 2017
- Subjects: AIDS (Disease) -- South Africa -- Eastern Cape -- Prevention , HIV-positive persons -- South Africa -- Eastern Cape , HIV infections -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/15012 , vital:40132
- Description: The study investigated the experiences encountered by female adults from Ntselamanzi living with Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) and using Anti-retroviral (ARV) treatment. The study used a qualitative approach as well as a case study design that was descriptive explorative and explanative. The sample size or the unit of analysis consisted of 29 participants who included 12 female adults living with HIV/AIDS and having used ARVs for a minimum of three months; six nurses directly serving the people living with HIV/AIDS (PLWHA); six family members catering for the infected members within their family setting; and five key informants that included a social worker, a community leader, a health promoter, a community developer, and an HIV co-ordinator situated within the community of Ntselamanzi. A non-probability sampling method was adopted, specifically incorporating both snowball and purposive sampling techniques to select the sample. Significantly, the study was led by the following objectives: (1) To explore the experiences of female adults living with HIV/AIDS in Ntselamanzi, (2) To establish the coping mechanisms adopted by the PLWHA (3) To determine the effects of coping challenges and the adherence to ARVs. The data was collected by means of face-toface in-depth interviews in tandem with focus group discussion (FGD); and it was analysed qualitatively using content thematic analysis. The findings of the study revealed that all female adults living with HIV/AIDS and using ARVs encountered innumerable challenges that impaired their coping. The findings also indicated that malfunctioning and interruption of PLWHA coping was influenced by social factors such as unemployment, high level of poverty, low educational levels, lack of information sharing programmes and dependency on social grants. Lastly, the support to PLWHA especially by family members was highly indicated in the study’s findings. The following recommendations emanated from the study: strengthening research on coping challenges of female adults using ARVs in rural areas; empowering and training more caregivers for PLWHA by the Health Department; more involvement of social workers in helping the PLWHA; more involvement of government in the HIV/AIDS campaign in rural settings; and government facilitation and support to the PLWHA to form and belong to support groups.
- Full Text:
- Authors: Matumelo, Nobuhle
- Date: 2017
- Subjects: AIDS (Disease) -- South Africa -- Eastern Cape -- Prevention , HIV-positive persons -- South Africa -- Eastern Cape , HIV infections -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MSoc
- Identifier: http://hdl.handle.net/10353/15012 , vital:40132
- Description: The study investigated the experiences encountered by female adults from Ntselamanzi living with Human Immunodeficiency Virus/ Acquired Immune Deficiency Syndrome (HIV/AIDS) and using Anti-retroviral (ARV) treatment. The study used a qualitative approach as well as a case study design that was descriptive explorative and explanative. The sample size or the unit of analysis consisted of 29 participants who included 12 female adults living with HIV/AIDS and having used ARVs for a minimum of three months; six nurses directly serving the people living with HIV/AIDS (PLWHA); six family members catering for the infected members within their family setting; and five key informants that included a social worker, a community leader, a health promoter, a community developer, and an HIV co-ordinator situated within the community of Ntselamanzi. A non-probability sampling method was adopted, specifically incorporating both snowball and purposive sampling techniques to select the sample. Significantly, the study was led by the following objectives: (1) To explore the experiences of female adults living with HIV/AIDS in Ntselamanzi, (2) To establish the coping mechanisms adopted by the PLWHA (3) To determine the effects of coping challenges and the adherence to ARVs. The data was collected by means of face-toface in-depth interviews in tandem with focus group discussion (FGD); and it was analysed qualitatively using content thematic analysis. The findings of the study revealed that all female adults living with HIV/AIDS and using ARVs encountered innumerable challenges that impaired their coping. The findings also indicated that malfunctioning and interruption of PLWHA coping was influenced by social factors such as unemployment, high level of poverty, low educational levels, lack of information sharing programmes and dependency on social grants. Lastly, the support to PLWHA especially by family members was highly indicated in the study’s findings. The following recommendations emanated from the study: strengthening research on coping challenges of female adults using ARVs in rural areas; empowering and training more caregivers for PLWHA by the Health Department; more involvement of social workers in helping the PLWHA; more involvement of government in the HIV/AIDS campaign in rural settings; and government facilitation and support to the PLWHA to form and belong to support groups.
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Vocational curriculum report 191(NATED) as a curriculum: a case study of three Eastern Cape TVET Colleges
- Authors: Sixabayi, Siyabonga Prince
- Date: 2016
- Subjects: Vocational education -- Curricula -- South Africa -- Eastern Cape Curriculum planning -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , Degree
- Identifier: http://hdl.handle.net/10353/5126 , vital:29089
- Description: This study aimed to investigate if there are any possible gaps in the offering Vocational Curriculum Report 191, in terms of knowledge, skills and link to the world of work. This study was a case study of three Technical and Vocational Education and Training Colleges that offer Vocational Curriculum Report 191, and it was geographically limited to the province of the Eastern Cape. The five main findings from this study were that firstly, the curriculum offers theory without practice. Secondly, there is a mismatch between what is offered as curriculum at Technical and Vocational Education and Training Colleges and what the labour market wants. Thirdly, lecturers do not have the practical exposure that relates to their fields of study. Fourthly, Vocational Curriculum Report 191 does not promote self-employment of its students and lastly, the curriculum is outdated and does not comply with the criteria of current employment opportunities. The study recommends that the curriculum be reviewed and revised. Technical and Vocational Education and Training colleges need to have in site practice facilities to cater for the practical application of theoretical knowledge of students. Partnerships between Technical and Vocational Education and Training Colleges, the labour market and Sector Education and Training Authorities are strongly recommended in this study.
- Full Text:
- Authors: Sixabayi, Siyabonga Prince
- Date: 2016
- Subjects: Vocational education -- Curricula -- South Africa -- Eastern Cape Curriculum planning -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , Degree
- Identifier: http://hdl.handle.net/10353/5126 , vital:29089
- Description: This study aimed to investigate if there are any possible gaps in the offering Vocational Curriculum Report 191, in terms of knowledge, skills and link to the world of work. This study was a case study of three Technical and Vocational Education and Training Colleges that offer Vocational Curriculum Report 191, and it was geographically limited to the province of the Eastern Cape. The five main findings from this study were that firstly, the curriculum offers theory without practice. Secondly, there is a mismatch between what is offered as curriculum at Technical and Vocational Education and Training Colleges and what the labour market wants. Thirdly, lecturers do not have the practical exposure that relates to their fields of study. Fourthly, Vocational Curriculum Report 191 does not promote self-employment of its students and lastly, the curriculum is outdated and does not comply with the criteria of current employment opportunities. The study recommends that the curriculum be reviewed and revised. Technical and Vocational Education and Training colleges need to have in site practice facilities to cater for the practical application of theoretical knowledge of students. Partnerships between Technical and Vocational Education and Training Colleges, the labour market and Sector Education and Training Authorities are strongly recommended in this study.
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Risky sexual behaviour in child headed families: A case study of Qora village, Idutywa, Eastern Cape Province
- Authors: Ntutumbo, Nyameka
- Date: 2015
- Subjects: Teenagers -- Sexual behavior -- South Africa -- Eastern Cape Orphans -- Sexual behavior -- South Africa -- Eastern Cape Risk-taking (Psychology)
- Language: English
- Type: Thesis , Masters , Degree
- Identifier: http://hdl.handle.net/10353/5213 , vital:29113
- Description: The study considered the prevalence of risky sexual behaviour in child headed families that usually affects the adolescents in South Africa. This study aimed at exploring the prevalence of risky sexual behaviour in child headed families, determining the causal factors of sexual promiscuous behaviour and effects of promiscuity. The area of investigation was Qora Village which is in a small town called Idutywa, Eastern Cape. This is an area that is characterised by poverty, illiteracy and unemployment. The sample was comprised of 50 participants and the study was conducted in two phases using mixed methods approach. Social exchange theory underpinned the study. Findings highlighted that these child headed adolescents had a role of caregivers and due to poverty they practiced risky sexual behaviour to bridge the economic gap. Furthermore, teenagers living in child headed families were likely to engage in risky sexual behaviour with people who are older than them; others are forced and coerced; while others perceive such act as a better option to bridge the economic gap that existed within their family backgrounds.
- Full Text:
- Authors: Ntutumbo, Nyameka
- Date: 2015
- Subjects: Teenagers -- Sexual behavior -- South Africa -- Eastern Cape Orphans -- Sexual behavior -- South Africa -- Eastern Cape Risk-taking (Psychology)
- Language: English
- Type: Thesis , Masters , Degree
- Identifier: http://hdl.handle.net/10353/5213 , vital:29113
- Description: The study considered the prevalence of risky sexual behaviour in child headed families that usually affects the adolescents in South Africa. This study aimed at exploring the prevalence of risky sexual behaviour in child headed families, determining the causal factors of sexual promiscuous behaviour and effects of promiscuity. The area of investigation was Qora Village which is in a small town called Idutywa, Eastern Cape. This is an area that is characterised by poverty, illiteracy and unemployment. The sample was comprised of 50 participants and the study was conducted in two phases using mixed methods approach. Social exchange theory underpinned the study. Findings highlighted that these child headed adolescents had a role of caregivers and due to poverty they practiced risky sexual behaviour to bridge the economic gap. Furthermore, teenagers living in child headed families were likely to engage in risky sexual behaviour with people who are older than them; others are forced and coerced; while others perceive such act as a better option to bridge the economic gap that existed within their family backgrounds.
- Full Text:
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