Bensham Hospital

Globally, 43 million people are living with HIV, 90% in developing countries. Increasing life expectancy with combination antiretroviral therapy (cART) results in chronic complications, including HIV-associated neurocognitive disorders (HAND) and eye diseases. HAND screening is currently challenging. Our aim was to evaluate clinical utility of retinopathy as a screening measure of HAND in older cART-treated individuals in Tanzania and feasibility of smartphone-based retinal screening in this low-resource setting. A cross-sectional systematic sample aged ≥ 50-years attending routine HIV follow-up in Tanzania were comprehensively assessed for HAND by American Academy of Neurology criteria and received ophthalmic assessment including smartphone-based retinal imaging. HAND and ophthalmic assessments were independent and blinded. Diagnostic accuracy was evaluated by AUROC curves. Of 129 individuals assessed, 69.8% were visually impaired. Thirteen had retinopathy. HAND prevalence was 66.7%. Retinopathy was significantly associated with HAND but HIV-disease factors (CD4, viral load) were not. Diagnostic accuracy of retinopathy for HAND was poor (AUROC 0.545-0.617) but specificity and positive predictive value were high. We conclude that ocular pathology and HAND appear highly prevalent in this low-resource setting. Although retinal screening cannot be used alone identify HAND, prioritization of individuals with abnormal retinal screening is a potential strategy in low-resource settings.

Parallels from visual processing support Doris's cognitive architecture underlying moral agency. Unconscious visual processes change with conscious reflection. The sparse and partial representations of vision, its illusions, and hallucinations echo biases in moral reasoning and behaviour. Traditionally, unconscious moral processes are developed by teaching and reflection. Modern neuroscience could bypass reflection and directly influence unconscious processes, creating new dangers.

A new type of sampling scheme for process fraction nonconforming is proposed for the simultaneous acceptance inspection of any number of large lots of similar size, which provides the advantage of scale without losing the ability to sentence lots individually. The methodology is described and illustrated by a flow chart. Attributes and variables sampling schemes are developed. For beta prior probability density functions for the process fractions nonconforming, formulae are derived for the expected proportion of lots accepted and the expected number of items inspected per lot. The advantages of the method are illustrated by some examples.

This commentary is intended to start a discussion about whether people should be allowed to modify, translate, adapt or sell copyrighted questionnaires without the permission of the developer (copyright-holder).

The Mazruiana Collection: a comprehensive annotated bibliography of the published works of Ali Mazrui, 1962–1997 by ABDUL SAMED BEMATH New Delhi and London: Institute of Muslim Minority Affairs, 1998. Pp.348. £39.00. - Volume 38 Issue 4

The Media in Africa and Africa in the Media: An Annotated Bibliography by Gretchen Walsh. London, Melbourne, Munich and New Providence, Hans Zell Publishers, 1996. Pp. 291, Hb. £55.00. - Volume 36 Issue 2