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Sample records for prioritizing hiv programmes

  1. Prioritization of Programmer's Productivity Using Analytic Hierarchy ...

    African Journals Online (AJOL)

    This paper focuses on the application of Analytic Hierarchy Process (AHP) model in the context of prioritizing programmer's productivity in University of Benin, Benin City Nigeria. This is achieved by evaluating the way in which the AHP model can be used to select the best programmer for the purpose of developing software ...

  2. PHIRST Trial - pharmacist consults: prioritization of HIV-patients with a referral screening tool.

    Science.gov (United States)

    Awad, Catherine; Canneva, Arnaud; Chiasson, Charles-Olivier; Galarneau, Annie; Schnitzer, Mireille E; Sheehan, Nancy L; Wong, Alison Yj

    2017-11-01

    The role of pharmacists in HIV outpatient clinics has greatly increased in the past decades. Given the limited resources of the health system, the prioritization of pharmacist consults is now a main concern. This study aimed to create a scoring system allowing for standardized prioritization of pharmacist consults for patients living with HIV. Data was retrospectively collected from 200 HIV patients attending the Chronic Viral Illness Service at the McGill University Health Center. An expert panel consisting of four pharmacists working in the field of HIV prioritized each patient individually, after which a consensus was established and was considered as the gold standard. In order to create a scoring system, two different methods (Delphi, statistical) were used to assign a weight to each characteristic considered to be important in patient prioritization. A third method (equal weight to each characteristic) was also evaluated. The total score per patient for each method was then compared to the expert consensus in order to establish the score cut-offs to indicate the appropriate categories of delay in which to see the patient. All three systems failed to accurately prioritize patients into urgency categories ("less than 48 h", "less than 1 month", "less than 3 months", "no consult required") according to expert pharmacist consensus. The presence of high level interactions between patient characteristics, the limited number of patients and the low prevalence of some characteristics were hypothesized as the main causes for the results. Creating a prioritization tool for pharmacy consults in HIV outpatient clinics is a complex task and developing a decision tree algorithm may be a more appropriate approach in the future to take into account the importance of combinations of patient characteristic.

  3. Availability of HIV/AIDS community intervention programmes and ...

    African Journals Online (AJOL)

    As a result, mining sites are at great risk of HIV transmission. While a ... Both quantitative and qualitative methods were used to collect data. ... The programmes carried out intervention activities which included HIV/AIDS education campaigns, ...

  4. Criteria for prioritization of HIV programs in Viet Nam: a discrete choice experiment

    Directory of Open Access Journals (Sweden)

    Ali Safarnejad

    2017-11-01

    Full Text Available Abstract Background With the decline in funding for Viet Nam’s response to the HIV epidemic, there is a need for evidence on the criteria to guide the prioritization of HIV programs. There is a gap in the research on the relative importance of multiple criteria for prioritizing a package of interventions. This study elicits preferences and the trade-offs made between different HIV programs by relevant stakeholders and decision-makers in Viet Nam. It also pays attention to how differences in social and professional characteristics of stakeholders and their agency affiliations shape preferences for HIV program criteria in Viet Nam. Methods This study uses self-explicated ranking and discrete choice experiments to determine the relative importance of five criteria - effectiveness, feasibility, cost-effectiveness, rate of investment and prevention/treatment investment ratio - to stakeholders when they evaluate and select hypothetical HIV programs. The study includes 69 participants from government, civil society, and international development partners. Results Results of the discrete choice experiment show that overall the feasibility criterion is ranked highest in importance to the participants when choosing a hypothetical HIV program, followed by sustainability, treatment to prevention spending ratio, and effectiveness. The participant’s work in management, programming, or decision-making has a significant effect on the importance of some criteria to the participant. In the self-explicated ranking effectiveness is the most important criterion and the cost-effectiveness criterion ranks low in importance across all groups. Conclusions This study has shown that the preferred HIV program in Viet Nam is feasible, front-loaded for sustainability, has a higher proportion of investment on prevention, saves more lives and prevents more infections. Similarities in government and civil society rankings of criteria can create common grounds for future

  5. Criteria for prioritization of HIV programs in Viet Nam: a discrete choice experiment.

    Science.gov (United States)

    Safarnejad, Ali; Pavlova, Milena; Son, Vo Hai; Phuong, Huynh Lan; Groot, Wim

    2017-11-13

    With the decline in funding for Viet Nam's response to the HIV epidemic, there is a need for evidence on the criteria to guide the prioritization of HIV programs. There is a gap in the research on the relative importance of multiple criteria for prioritizing a package of interventions. This study elicits preferences and the trade-offs made between different HIV programs by relevant stakeholders and decision-makers in Viet Nam. It also pays attention to how differences in social and professional characteristics of stakeholders and their agency affiliations shape preferences for HIV program criteria in Viet Nam. This study uses self-explicated ranking and discrete choice experiments to determine the relative importance of five criteria - effectiveness, feasibility, cost-effectiveness, rate of investment and prevention/treatment investment ratio - to stakeholders when they evaluate and select hypothetical HIV programs. The study includes 69 participants from government, civil society, and international development partners. Results of the discrete choice experiment show that overall the feasibility criterion is ranked highest in importance to the participants when choosing a hypothetical HIV program, followed by sustainability, treatment to prevention spending ratio, and effectiveness. The participant's work in management, programming, or decision-making has a significant effect on the importance of some criteria to the participant. In the self-explicated ranking effectiveness is the most important criterion and the cost-effectiveness criterion ranks low in importance across all groups. This study has shown that the preferred HIV program in Viet Nam is feasible, front-loaded for sustainability, has a higher proportion of investment on prevention, saves more lives and prevents more infections. Similarities in government and civil society rankings of criteria can create common grounds for future policy dialogues between stakeholders. Innovative models of planning should

  6. Effects of an exercise programme with people living with HIV ...

    African Journals Online (AJOL)

    Effects of an exercise programme with people living with HIV: research in a disadvantaged setting. Clemens Ley, Lloyd Leach, María Rato Barrio, Susan Bassett. Abstract. This study aimed to analyse the physical health effects of a community based 10-week physical activity programme with people living with HIV.

  7. How to integrate water, sanitation, and hygiene into HIV programmes

    National Research Council Canada - National Science Library

    Bery, Renuka; Rosenbaum, Julia

    2010-01-01

    "Water, sanitation and hygiene (WASH) practices are essential for maintaining health, yet most countries and donors have not included WASH in national policies and programmes for human immunodeficiency virus (HIV...

  8. The Global Fund's resource allocation decisions for HIV programmes

    DEFF Research Database (Denmark)

    Avdeeva, Olga; Lazarus, Jeff; Aziz, Mohamed Abdel

    2011-01-01

    Between 2002 and 2010, the Global Fund to Fight AIDS, Tuberculosis and Malaria's investment in HIV increased substantially to reach US$12 billion. We assessed how the Global Fund's investments in HIV programmes were targeted to key populations in relation to disease burden and national income....

  9. Antiretroviral therapy programme on control of HIV transmission in ...

    African Journals Online (AJOL)

    Antiretroviral therapy programme on control of HIV transmission in Morogoro municipality, Tanzania: A challenge for development. ... The government and partners should improve access to ART services to enable many PLHIV to access the services. Key words: Antiretroviral Therapy, Highly Active Antiretroviral Treatment, ...

  10. Hypertension and obesity among HIV patients in a care programme ...

    African Journals Online (AJOL)

    Objective: To determine the prevalence of hypertension and obesity among HIV patients enrolled in the Sex Worker Outreach Programme (SWOP), Nairobi, Kenya. Design: A retrospective a study. Setting: SWOP managed by the University of Manitoba, Nairobi team. Subjects: We selected clinic visit records from HIV ...

  11. PRIORITIZED ACTIONS FOR MARKETING IMPROVEMENT: A TOOL FOR SMALL BUSINESS MARKETING PROGRAMMES

    OpenAIRE

    Nikola Rovis

    2010-01-01

    Purpose of this paper is to offer a pragmatic tool for management and marketing practitioners in small businesses. The name of the tool is Prioritized Action for Marketing Improvements (PAMI). This work gives an overview of marketing and strategy processes in small businesses and a brief description of Dibb and Simkin buying proforma tool. The PAMI tool builds on successfully conducted market segmentation and specification or implicit knowledge on targeted market segments and market positioni...

  12. Transitioning from antenatal surveillance surveys to routine HIV testing: a turning point in the mother-to-child transmission prevention programme for HIV surveillance in Brazil.

    Science.gov (United States)

    Pereira, Gerson Fernando Mendes; Sabidó, Meritxell; Caruso, Alessandro; Benzaken, Adele Schwartz

    2017-07-05

    In Brazil, due to the rapid increase in programmes for the prevention of mother-to-child transmission (PMTCT), routine programme data are widely available. The objective of this study was to assess the utility of programmatic data to replace HIV surveillance based on the antenatal care (ANC) surveillance survey (SS). We analysed ANC SS data from 219 maternity service clinics. PMTCT variables were extracted from the ANC SS data collection form, which allowed us to capture and compare the ANC SS data and PMTCT HIV test results for each pregnant woman who completed the ANC SS. Both the PMTCT programme and the ANC SS tested for HIV using sequential ELISA and western blot for confirmation. We assessed the completeness (% missing) of the PMTC data included in the ANC SS. Of the 36,713 pregnant women who had ANC SS HIV tests performed, 30,588 also underwent PMTCT HIV testing. The HIV prevalence rate from routine PMTCT testing was 0.36%, compared to 0.38% from the ANC SS testing (relative difference -0.05%; absolute difference -0.02%). The relative difference in prevalence rates between pregnant women in northern Brazil and pregnant women central-west Brazil was -0.98 and 0.66, respectively. Of the 29,856 women who had HIV test results from both the PMTCT and ANC SS, the positive percent agreement of the PMTCT versus the surveillance test was 84.1% (95% confidence interval [CI]: 74.8-91.0), and the negative percent agreement was 99.9% (95% CI: 99.9-100.0). The PMTCT HIV testing uptake was 86.4%. The ANC SS HIV prevalence was 0.33% among PMTCT non-refusers and 0.59% among refusers, with a percent bias of -10.80% and a differential prevalence ratio of 0.56. Syphilis and HIV testing results were complete in 98% and 97.6% of PMTCT reports, respectively. The reported HIV status for the women at clinic entry was missing. Although there were consistent HIV prevalence estimates from the PMTCT data and the ANC SS, the overall positive percent agreement of 84.1% falls below the

  13. Developing consumer involvement in rural HIV primary care programmes.

    Science.gov (United States)

    Mamary, Edward M; Toevs, Kim; Burnworth, Karla B; Becker, Lin

    2004-06-01

    As part of a broader medical and psychosocial needs assessment in a rural region of northern California, USA, five focus groups were conducted to explore innovative approaches to creating a system of consumer involvement in the delivery of HIV primary care services in the region. A total of five focus groups (n = 30) were conducted with clients from three of five counties in the region with the highest number of HIV patients receiving primary care. Participants were recruited by their HIV case managers. They were adults living with HIV, who were receiving health care, and who resided in a rural mountain region of northern California. Group discussions explored ideas for new strategies and examined traditional methods of consumer involvement, considering ways they could be adapted for a rural environment. Recommendations for consumer involvement included a multi-method approach consisting of traditional written surveys, a formal advisory group, and monthly consumer led social support/informal input groups. Specific challenges discussed included winter weather conditions, transportation barriers, physical limitations, confidentiality concerns, and needs for social support and education. A multiple-method approach would ensure more comprehensive consumer involvement in the programme planning process. It is also evident that methods for incorporating consumer involvement must be adapted to the specific context and circumstances of a given programme.

  14. Intersectionality of HIV stigma and masculinity in eastern Uganda: implications for involving men in HIV programmes.

    Science.gov (United States)

    Mburu, Gitau; Ram, Mala; Siu, Godfrey; Bitira, David; Skovdal, Morten; Holland, Paula

    2014-10-11

    considered. In particular, better integration of and linkage between gender transformative interventions that support men to reconstruct their male identities and reject signifiers of masculinity that prevent their access to HIV services, and stigma-reduction interventions that target social and structural drivers of stigma is required within HIV programmes.

  15. An appraisal of female sex work in Nigeria--implications for designing and scaling up HIV prevention programmes.

    Science.gov (United States)

    Ikpeazu, Akudo; Momah-Haruna, Amaka; Madu Mari, Baba; Thompson, Laura H; Ogungbemi, Kayode; Daniel, Uduak; Aboki, Hafsatu; Isac, Shajy; Gorgens, Marelize; Mziray, Elizabeth; Njie, Ndella; Akala, Francisca Ayodeji; Emmanuel, Faran; Odek, Willis Omondi; Blanchard, James F

    2014-01-01

    The HIV epidemic in Nigeria is complex with diverse factors driving the epidemic. Accordingly, Nigeria's National Agency for the Control of AIDS is coordinating a large-scale initiative to conduct HIV epidemic appraisals across all states. These appraisals will help to better characterize the drivers of the epidemic and ensure that the HIV prevention programmes match the local epidemic context, with resources allocated to interventions that have the greatest impact locally. Currently, the mapping and size estimation of Female Sex Workers (FSWs)--a major component of the appraisal has been completed in seven states. These states are using the data generated to plan, prioritize and scale-up sub-national HIV prevention programmes. It involved a two-level process of identifying and validating locations where FSWs solicit and/or meet clients ("hotspots"). In the first level, secondary key informants were interviewed to collect information about the geographic location and description of the hotspots. For the second level, FSWs were interviewed at each hotspot and information on population size estimates, typologies and operational dynamics of the FSWs were collected. Across the seven states, a total of 17,266 secondary key informants and 5,732 FSWs were interviewed. 10,233 hotspots were identified with an estimated 126,489 FSWs ranging from 5,920 in Anambra to 46,691 in Lagos. The most common hotspots were bars/nightclubs (30%), hotels/lodges (29.6%), streets (16.6%), and brothels (14.6%). Furthermore, the population density of FSWs (per thousand adult men) across the states ranged from 2 in Anambra to 17 in the Federal Capital Territory. FSW populations in Nigeria are large and diverse, with substantial differences between and within states. Improved understanding of the location, population size, density, organizational typologies and clients of sex work has informed and is central to Nigeria's planning process for scaling up focused HIV prevention programmes.

  16. An Appraisal of Female Sex Work in Nigeria - Implications for Designing and Scaling Up HIV Prevention Programmes

    Science.gov (United States)

    Ikpeazu, Akudo; Momah-Haruna, Amaka; Madu Mari, Baba; Thompson, Laura H.; Ogungbemi, Kayode; Daniel, Uduak; Aboki, Hafsatu; Isac, Shajy; Gorgens, Marelize; Mziray, Elizabeth; Njie, Ndella; Akala, Francisca Ayodeji; Emmanuel, Faran; Odek, Willis Omondi; Blanchard, James F.

    2014-01-01

    Background The HIV epidemic in Nigeria is complex with diverse factors driving the epidemic. Accordingly, Nigeria's National Agency for the Control of AIDS is coordinating a large-scale initiative to conduct HIV epidemic appraisals across all states. These appraisals will help to better characterize the drivers of the epidemic and ensure that the HIV prevention programmes match the local epidemic context, with resources allocated to interventions that have the greatest impact locally. Currently, the mapping and size estimation of Female Sex Workers (FSWs) - a major component of the appraisal has been completed in seven states. These states are using the data generated to plan, prioritize and scale-up sub-national HIV prevention programmes. Methodology It involved a two-level process of identifying and validating locations where FSWs solicit and/or meet clients (“hotspots”). In the first level, secondary key informants were interviewed to collect information about the geographic location and description of the hotspots. For the second level, FSWs were interviewed at each hotspot and information on population size estimates, typologies and operational dynamics of the FSWs were collected. Results Across the seven states, a total of 17,266 secondary key informants and 5,732 FSWs were interviewed. 10,233 hotspots were identified with an estimated 126,489 FSWs ranging from 5,920 in Anambra to 46,691 in Lagos. The most common hotspots were bars/nightclubs (30%), hotels/lodges (29.6%), streets (16.6%), and brothels (14.6%). Furthermore, the population density of FSWs (per thousand adult men) across the states ranged from 2 in Anambra to 17 in the Federal Capital Territory. Conclusion FSW populations in Nigeria are large and diverse, with substantial differences between and within states. Improved understanding of the location, population size, density, organizational typologies and clients of sex work has informed and is central to Nigeria's planning process for

  17. An appraisal of female sex work in Nigeria--implications for designing and scaling up HIV prevention programmes.

    Directory of Open Access Journals (Sweden)

    Akudo Ikpeazu

    Full Text Available BACKGROUND: The HIV epidemic in Nigeria is complex with diverse factors driving the epidemic. Accordingly, Nigeria's National Agency for the Control of AIDS is coordinating a large-scale initiative to conduct HIV epidemic appraisals across all states. These appraisals will help to better characterize the drivers of the epidemic and ensure that the HIV prevention programmes match the local epidemic context, with resources allocated to interventions that have the greatest impact locally. Currently, the mapping and size estimation of Female Sex Workers (FSWs--a major component of the appraisal has been completed in seven states. These states are using the data generated to plan, prioritize and scale-up sub-national HIV prevention programmes. METHODOLOGY: It involved a two-level process of identifying and validating locations where FSWs solicit and/or meet clients ("hotspots". In the first level, secondary key informants were interviewed to collect information about the geographic location and description of the hotspots. For the second level, FSWs were interviewed at each hotspot and information on population size estimates, typologies and operational dynamics of the FSWs were collected. RESULTS: Across the seven states, a total of 17,266 secondary key informants and 5,732 FSWs were interviewed. 10,233 hotspots were identified with an estimated 126,489 FSWs ranging from 5,920 in Anambra to 46,691 in Lagos. The most common hotspots were bars/nightclubs (30%, hotels/lodges (29.6%, streets (16.6%, and brothels (14.6%. Furthermore, the population density of FSWs (per thousand adult men across the states ranged from 2 in Anambra to 17 in the Federal Capital Territory. CONCLUSION: FSW populations in Nigeria are large and diverse, with substantial differences between and within states. Improved understanding of the location, population size, density, organizational typologies and clients of sex work has informed and is central to Nigeria's planning

  18. Genital infections and syndromic diagnosis among HIV-infected women in HIV care programmes in Kenya.

    Science.gov (United States)

    Djomand, Gaston; Gao, Hongjiang; Singa, Benson; Hornston, Sureyya; Bennett, Eddas; Odek, James; McClelland, R Scott; John-Stewart, Grace; Bock, Naomi

    2016-01-01

    Control of genital infections remains challenging in most regions. Despite advocacy by the World Health Organization for syndromic case management, there are limited data on the syndromic approach, especially in HIV care settings. This study compared the syndromic approach with laboratory diagnosis among women in HIV care in Kenya. A mobile team visited 39 large HIV care programmes in Kenya and enrolled participants using population-proportionate sampling. Participants provided behavioural and clinical data with genital and blood specimens for lab testing. Among 1063 women, 68.4% had been on antiretroviral therapy >1 year; 58.9% were using cotrimoxazole prophylaxis; 51 % had CD4+T-lymphocytes Kenya have high rates of vaginal infections. Syndromic diagnosis was a poor predictor of those infections. © The Author(s) 2015.

  19. Evaluation of an HIV/AIDS peer education programme in a South ...

    African Journals Online (AJOL)

    Objectives. To evaluate a South African workplace HIV I AIDS peer-education programme running since 1997. Methods. In 2001 a cross-sectional study was done of 900 retail-section employees in three geographical areas. The study measured HIV I AIDS knowledge, attitudes towards people living with HIV I AIDS, belief ...

  20. Should HIV and AIDS workplace programmes still be advocated in the automotive industry?

    OpenAIRE

    Liana Steenkamp; Jill von der Marwitz; Friederike Baasner-Weihs; Jacques Pietersen

    2015-01-01

    Orientation: In light of the human immunodeficiency virus (HIV) pandemic, and in order to improve competitiveness in the South African private sector, many structures have implemented subsidised workplace programmes. Research purpose: The aim of this study was to collect baseline data regarding the knowledge, attitudes, practices and belief (KAPB) of employees in the automotive industry in relation to HIV and AIDS, in order to assess the need for HIV and AIDS workplace programmes. Mot...

  1. Monitoring and evaluation of sport-based HIV/AIDS awareness programmes: Strengthening outcome indicators

    Directory of Open Access Journals (Sweden)

    Elma Nelisiwe Maleka

    2017-01-01

    Full Text Available There are number of Non-Governmental Organisations (NGOs in South Africa that use sport as a tool to respond to Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS, however, little is reported about the outcomes and impact of these programmes. The aim of this study is to contribute to a generic monitoring and evaluation framework by improving the options for the use of outcome indicators of sport-based HIV/AIDS awareness programmes of selected NGOs in South Africa. A qualitative method study was carried out with seven employees of five selected NGOs that integrate sport to deliver HIV/AIDS programmes in South Africa. The study further involved six specialists/experts involved in the field of HIV/AIDS and an official from Sport Recreation South Africa (SRSA. Multiple data collection instruments including desktop review, narrative systematic review, document analysis, one-on-one interviews and focus group interview were used to collect information on outcomes and indicators for sport-based HIV/AIDS awareness programmes. The information was classified according to the determinants of HIV/AIDS. The overall findings revealed that the sport-based HIV/AIDS awareness programmes of five selected NGOs examined in this study focus on similar HIV prevention messages within the key priorities highlighted in the current National Strategic Plan for HIV/AIDS, STIs and TB of South Africa. However, monitoring and evaluating outcomes of sport-based HIV/AIDS programmes of the selected NGOs remains a challenge. A need exists for the improvement of the outcome statements and indicators for their sport-based HIV/AIDS awareness programmes. This study proposed a total of 51 generic outcome indicators focusing on measuring change in the knowledge of HIV/AIDS and change in attitude and intention towards HIV risk behaviours. In addition, this study further proposed a total of eight generic outcome indicators to measure predictors of HIV risk behaviour

  2. Monitoring and evaluation of sport-based HIV/AIDS awareness programmes: Strengthening outcome indicators.

    Science.gov (United States)

    Maleka, Elma Nelisiwe

    2017-12-01

    There are number of Non-Governmental Organisations (NGOs) in South Africa that use sport as a tool to respond to Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), however, little is reported about the outcomes and impact of these programmes. The aim of this study is to contribute to a generic monitoring and evaluation framework by improving the options for the use of outcome indicators of sport-based HIV/AIDS awareness programmes of selected NGOs in South Africa. A qualitative method study was carried out with seven employees of five selected NGOs that integrate sport to deliver HIV/AIDS programmes in South Africa. The study further involved six specialists/experts involved in the field of HIV/AIDS and an official from Sport Recreation South Africa (SRSA). Multiple data collection instruments including desktop review, narrative systematic review, document analysis, one-on-one interviews and focus group interview were used to collect information on outcomes and indicators for sport-based HIV/AIDS awareness programmes. The information was classified according to the determinants of HIV/AIDS. The overall findings revealed that the sport-based HIV/AIDS awareness programmes of five selected NGOs examined in this study focus on similar HIV prevention messages within the key priorities highlighted in the current National Strategic Plan for HIV/AIDS, STIs and TB of South Africa. However, monitoring and evaluating outcomes of sport-based HIV/AIDS programmes of the selected NGOs remains a challenge. A need exists for the improvement of the outcome statements and indicators for their sport-based HIV/AIDS awareness programmes. This study proposed a total of 51 generic outcome indicators focusing on measuring change in the knowledge of HIV/AIDS and change in attitude and intention towards HIV risk behaviours. In addition, this study further proposed a total of eight generic outcome indicators to measure predictors of HIV risk behaviour. The selected

  3. Traditional healers, HIV/AIDS and company programmes in South ...

    African Journals Online (AJOL)

    Traditional healers' diverse and fluid beliefs about HIV and AIDS are ... healing practices could be promoted in workplace responses to HIV/AIDS. ... as help coordinate a wider and more effective response to the HIV epidemic in South Africa.

  4. Comparing HIV prevalence estimates from prevention of mother-to-child HIV transmission programme and the antenatal HIV surveillance in Addis Ababa

    Directory of Open Access Journals (Sweden)

    Mirkuzie Alemnesh H

    2012-12-01

    Full Text Available Abstract Background In the absence of reliable data, antenatal HIV surveillance has been used to monitor the HIV epidemic since the late 1980s. Currently, routine data from Prevention of Mother-to-child HIV transmission (PMTCT programmes are increasingly available. Evaluating whether the PMTCT programme reports provide comparable HIV prevalence estimates with the antenatal surveillance reports is important. In this study, we compared HIV prevalence estimates from routine PMTCT programme and antenatal surveillance in Addis Ababa with the aim to come up with evidence based recommendation. Methods Summary data were collected from PMTCT programmes and antenatal surveillance reports within the catchment of Addis Ababa. The PMTCT programme data were obtained from routine monthly reports from 2004 to 2009 and from published antenatal HIV surveillance reports from 2003 to 2009. Data were analysed using descriptive statistics. Results In Addis Ababa, PMTCT sites had increased from six in 2004 to 54 in 2009. The site expansion was accompanied by an increased number of women testing. There were marked increases in the rate of HIV testing following the introduction of routine opt-out HIV testing approach. Paralleling these increases, the HIV prevalence showed a steady decline from 10.0% in 2004 to 4.5% in 2009. There were five antenatal surveillance sites from 2003 to 2007 in Addis Ababa and they increased to seven by 2009. Four rounds of surveillance data from five sites showed a declining trend in HIV prevalence over the years. The overall antenatal surveillance data also showed that the HIV prevalence among antenatal attendees had declined from 12.4% in 2003 to 5.5% in 2009. The HIV prevalence estimates from PMTCT programme were 6.2% and 4.5% and from antenatal surveillance 6.1 and 5.5% in 2008 and 2009 respectively. Conclusions There were consistent HIV prevalence estimates from PMTCT programme and from antenatal surveillance reports. Both data sources

  5. Evaluation of an HIV/AIDS peer education programme South African ...

    African Journals Online (AJOL)

    HIV I AIDS peer-education programme for its employees aimed at addressing the growing ..... m:JI education intervention in a mining community reports essentially no effect.17 ... yet to be determined. Such data are crucial for the development.

  6. Evaluation of an HIV-risk reduction programme for first-year ...

    African Journals Online (AJOL)

    Results indicated that HIV-related knowledge; condom knowledge and risk perception were enhanced by the HIV- related risk reduction programme. However, there is a need for improvement, especially with regard to attitudes towards condoms since some students still had negative attitudes even after the intervention ...

  7. Voluntary Medical Male Circumcision for HIV Prevention: New Mathematical Models for Strategic Demand Creation Prioritizing Subpopulations by Age and Geography.

    Science.gov (United States)

    Hankins, Catherine; Warren, Mitchell; Njeuhmeli, Emmanuel

    2016-01-01

    Over 11 million voluntary medical male circumcisions (VMMC) have been performed of the projected 20.3 million needed to reach 80% adult male circumcision prevalence in priority sub-Saharan African countries. Striking numbers of adolescent males, outside the 15-49-year-old age target, have been accessing VMMC services. What are the implications of overall progress in scale-up to date? Can mathematical modeling provide further insights on how to efficiently reach the male circumcision coverage levels needed to create and sustain further reductions in HIV incidence to make AIDS no longer a public health threat by 2030? Considering ease of implementation and cultural acceptability, decision makers may also value the estimates that mathematical models can generate of immediacy of impact, cost-effectiveness, and magnitude of impact resulting from different policy choices. This supplement presents the results of mathematical modeling using the Decision Makers' Program Planning Tool Version 2.0 (DMPPT 2.0), the Actuarial Society of South Africa (ASSA2008) model, and the age structured mathematical (ASM) model. These models are helping countries examine the potential effects on program impact and cost-effectiveness of prioritizing specific subpopulations for VMMC services, for example, by client age, HIV-positive status, risk group, and geographical location. The modeling also examines long-term sustainability strategies, such as adolescent and/or early infant male circumcision, to preserve VMMC coverage gains achieved during rapid scale-up. The 2016-2021 UNAIDS strategy target for VMMC is an additional 27 million VMMC in high HIV-prevalence settings by 2020, as part of access to integrated sexual and reproductive health services for men. To achieve further scale-up, a combination of evidence, analysis, and impact estimates can usefully guide strategic planning and funding of VMMC services and related demand-creation strategies in priority countries. Mid-course corrections

  8. Voluntary Medical Male Circumcision for HIV Prevention: New Mathematical Models for Strategic Demand Creation Prioritizing Subpopulations by Age and Geography.

    Directory of Open Access Journals (Sweden)

    Catherine Hankins

    Full Text Available Over 11 million voluntary medical male circumcisions (VMMC have been performed of the projected 20.3 million needed to reach 80% adult male circumcision prevalence in priority sub-Saharan African countries. Striking numbers of adolescent males, outside the 15-49-year-old age target, have been accessing VMMC services. What are the implications of overall progress in scale-up to date? Can mathematical modeling provide further insights on how to efficiently reach the male circumcision coverage levels needed to create and sustain further reductions in HIV incidence to make AIDS no longer a public health threat by 2030? Considering ease of implementation and cultural acceptability, decision makers may also value the estimates that mathematical models can generate of immediacy of impact, cost-effectiveness, and magnitude of impact resulting from different policy choices. This supplement presents the results of mathematical modeling using the Decision Makers' Program Planning Tool Version 2.0 (DMPPT 2.0, the Actuarial Society of South Africa (ASSA2008 model, and the age structured mathematical (ASM model. These models are helping countries examine the potential effects on program impact and cost-effectiveness of prioritizing specific subpopulations for VMMC services, for example, by client age, HIV-positive status, risk group, and geographical location. The modeling also examines long-term sustainability strategies, such as adolescent and/or early infant male circumcision, to preserve VMMC coverage gains achieved during rapid scale-up. The 2016-2021 UNAIDS strategy target for VMMC is an additional 27 million VMMC in high HIV-prevalence settings by 2020, as part of access to integrated sexual and reproductive health services for men. To achieve further scale-up, a combination of evidence, analysis, and impact estimates can usefully guide strategic planning and funding of VMMC services and related demand-creation strategies in priority countries. Mid

  9. Are routine tuberculosis programme data suitable to report on antiretroviral therapy use of HIV-infected tuberculosis patients?

    NARCIS (Netherlands)

    Brouwer, Miranda; Gudo, Paula Samo; Simbe, Chalice Mage; Perdigão, Paula; van Leth, Frank

    2013-01-01

    Antiretroviral therapy (ART) is lifesaving for HIV-infected tuberculosis (TB) patients. ART-use by these patients lag behind compared to HIV-testing and co-trimoxazole preventive therapy. TB programmes provide the data on ART-use by HIV-infected TB patients, however often the HIV services provide

  10. Should HIV and AIDS workplace programmes still be advocated in the automotive industry?

    Directory of Open Access Journals (Sweden)

    Liana Steenkamp

    2015-03-01

    Full Text Available Orientation: In light of the human immunodeficiency virus (HIV pandemic, and in order to improve competitiveness in the South African private sector, many structures have implemented subsidised workplace programmes. Research purpose: The aim of this study was to collect baseline data regarding the knowledge, attitudes, practices and belief (KAPB of employees in the automotive industry in relation to HIV and AIDS, in order to assess the need for HIV and AIDS workplace programmes. Motivation for the study: Given the abundance of HIV and AIDS information, the question is whether these workplace programmes’ efforts are still relevant. Research design, approach and method: A quantitative descriptive study design was used using a self-administered questionnaire covering questions about KAPB with regard to HIV and AIDS. The data collection took place in seven automotive supplier companies in South Africa (n = 733 who were going to implement HIV and AIDS workplace programmes with the support of the Automotive Industry Development Centre in the Eastern Cape. Main findings: High-risk behaviour, as indicated by sexual relations with more than one partner in the last 12 months, occurred in between 12% (management and 42% (cleaners of employees. All risk behaviour indicators showed significant differences (p < 0.05 between management and administrative staff on the one hand and technicians, operators and cleaners on the other. Despite being aware of an HIV policy, more than 50% of employees indicated that they would not be willing to disclose their status. Practical/managerial implications: As HIV and AIDS risk behaviour and stigma remain a problem, HIV infection with associated health problems may threaten productivity in the automotive industry if no measures are taken to address the impact on employees and the company. Contribution: This study strongly supports the conclusion that KAPB studies can still provide important information to tailor HIV

  11. The intersection of antiretroviral therapy, peer support programmes, and economic empowerment with HIV stigma among HIV-positive women in West Nile Uganda.

    Science.gov (United States)

    Kellett, Nicole Coffey; Gnauck, Katherine

    2016-12-01

    HIV stigma remains a major problem of the AIDS epidemic in sub-Saharan Africa. Women fear impending social stigma including blame, isolation and abuse. HIV infection and HIV stigma interact cyclically, creating and reinforcing economic and social exclusion for individuals living with HIV. Evidence suggests that interventions for people living with HIV infection that include, in combination, antiretroviral therapy (ART), peer support and economic empowerment are likely to be more effective than if used alone. We report a qualitative study in West Nile Uganda that explored perceptions of HIV stigma among fifty-four HIV-positive women who had similar access to ART and HIV peer support programmes, but varying levels of participation (full-time, intermittent, none) in economic empowerment programmes. Our study found that access to ART, peer support groups, and economic empowerment programmes helped to curb perceptions of deep-seated HIV stigma for participants. More expressions of usefulness, hope and psychological well-being prevailed with participants who had increased participation in economic empowerment programmes. Our findings underscore the value of HIV outreach programmes which combine ART, peer support and economic empowerment to alleviate HIV stigma. Further research to quantify the interaction of these factors is warranted.

  12. Wits University's response to HIV/AIDS: flagship programme or ...

    African Journals Online (AJOL)

    HIV/AIDS is a threat to the creation of human capital and development prospects in southern Africa and South Africa. The University of the Witwatersrand (Wits) is a well-regarded institution of higher education in Johannesburg. This paper outlines the university's qualified failure to implement its HIV/AIDS Policy through a ...

  13. KHOMANANI: AN HIV AND AIDS COMMUNITY MOBILISATION PROGRAMME FOR RESOURCE-CONSTRAINED SETTINGS

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    Shilubane, Tlangelani

    2013-05-01

    Full Text Available An overview of HIV and AIDS statistics indicates that there were 31.6 million people living with HIV in 2010, and that 68% of those people were from Sub-Saharan Africa (UNAIDS, 2011:07. In South Africa, one of the countries in Sub-Saharan Africa, HIV prevalence among people between the ages of 15 and 49 has stabilised at 17.8%, with the absolute number of people living with HIV (PLHIV showing a steep increase of approximately 100 000 additional PLHIV each year. The number of people aged 15 and older living with HIV is estimated to be 5 300 000. These figures actually mean that one out of every six people with HIV in the world lives in South Africa (UNAIDS, 2011:21. The authors therefore postulate that these statistics encapsulate the devastation that HIV and AIDS is causing, particularly in South Africa, which arguably carries the heaviest HIV and AIDS burden in the world. Initially South Africa’s efforts to mitigate the impact of HIV and AIDS were characterised by programme designs which followed an inflexible biomedical approach that did not focus on the influence of socio-economic and structural factors in addressing the pandemic. This situation, among others, contributed to raise the country’s HIV infection growth rate to among the highest in the world (Kahn, 2006:4.

  14. Integrating eHealth in HIV/AIDS intervention programmes in South Africa

    Directory of Open Access Journals (Sweden)

    Babasile D. Osunyomi

    2015-03-01

    Objective: The key aim of this article is to explore the status quo of the implementation of information and communication technologies (ICTs in selected intervention programmes in the South African HIV/AIDS care delivery value chain. The contribution of this article is the mapping of key intervention activities along an HIV care value chain and to suggest a roadmap towards the integration of ICTs in service delivery programmes. Method: 20 managers of HIV/AIDS intervention programmes were surveyed, followed by semi-structured in-depth interviews with these respondents. A further five in-depth interviews were conducted with experts in the ICT area for exploring the uses of and barriers to integrating ICTs in the HIV/AIDS care delivery value chain. Results: The researchers mapped the barriers to implementation and ICT tools utilised within the HIV/AIDS care delivery value chain, which proves to be a useful tool to explore the status quo of technology in such service delivery programmes. The researchers then considered the wider policy environment and provided a roadmap based on the analysis and the South Africa eHealth strategy for driving development in this sector. Conclusion: The authors found that South Africa’s eHealth environment is still nascent and that the South African eHealth strategy does not place enough emphasis on systems integration and stakeholder engagement or the planning and process of uptake of ICTs by target audiences.

  15. Issues and Challenges of HIV/AIDS Prevention and Treatment Programme in Nepal

    OpenAIRE

    Wasti, Sharada Prasad; Simkhada, Padam; Randall, Julian; Van Teijlingen, Edwin

    2009-01-01

    This paper explores some of the key issues and challenges of government HIV/AIDS prevention and treatment programme in Nepal. Providing HIV/AIDS prevention and treatment services in Nepal is associated with a number of issues and challenges which are shaped mostly on cultural and managerial issues from grass root to policy level.\\ud Numerous efforts have been done and going on by Nepal government and non-government organization but still HIV\\ud prevention and treatment service is not able to ...

  16. The Simalelo Peer Education Programme for HIV prevention: a ...

    African Journals Online (AJOL)

    The aim of the project was to evaluate a peer education programme in Zambia run by local people in relation to changes in behaviours, the effects of the programme on the community and the dynamics of peer health promotion. A qualitative process evaluation using focus groups consisting of both participants in the peer ...

  17. Sociocultural dimensions of HIV/AIDS among Middle Eastern immigrants in the US: bridging culture with HIV/AIDS programmes.

    Science.gov (United States)

    Ehsanzadeh-Cheemeh, Parvaneh; Sadeque, Abul; Grimes, Richard M; Essien, E James

    2009-09-01

    The population of Middle Eastern immigrants in the US has been increasing dramatically over the past 30 years, growing from 200,000 in 1970 to 1.5 million in 2000. These immigrants and their descendants constitute an important new population of interest for public health and other social programmes. With this addition to the cultural diversity of American society, it is important for healthcare programmes to be responsive to the unique cultural needs of those of Middle Eastern origin and to include them in healthcare curricula. This need is particularly imperative for human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) intervention programmes, where the reduction of risky behaviours is essential to controlling the epidemic. When Middle Easterners emigrate to the US they must adjust to the American culture, which leads to preservation of some aspects of their culture and adjustment of behaviors to match American customs. This article aims to present sociocultural factors of HIV risk behaviours that are specific to Middle Eastern culture. The article also provides recommendations for HIV/AIDS-culturally appropriate intervention programmes.

  18. HIV prevention policy and programme planning: What can mathematical modelling contribute?

    NARCIS (Netherlands)

    Hankins, C.A.

    2014-01-01

    This thesis explores the potential contribution of mathematical modelling to informed decision-making on policy and programme planning for novel HIV prevention tools. Its hypothesis is that, under certain conditions, modelling results can be a useful addition to the evidence and other factors that

  19. Romantic Relationships: An Important Context for HIV/STI and Pregnancy Prevention Programmes with Young People

    Science.gov (United States)

    Coyle, Karin K.; Anderson, Pamela M.; Franks, Heather M.; Glassman, Jill; Walker, James D.; Charles, Vignetta Eugenia

    2014-01-01

    Romantic relationships are central in the lives of young people. This paper uses data on romantic relationships from urban youth in the USA to illustrate how using a relationships perspective in HIV/STI and pregnancy prevention programmes broadens the skills and content covered, and contextualises the learning to enhance relevance and use.…

  20. HIV rapid diagnostic testing by lay providers in a key population-led health service programme in Thailand.

    Science.gov (United States)

    Wongkanya, Rapeeporn; Pankam, Tippawan; Wolf, Shauna; Pattanachaiwit, Supanit; Jantarapakde, Jureeporn; Pengnongyang, Supabhorn; Thapwong, Prasopsuk; Udomjirasirichot, Apichat; Churattanakraisri, Yutthana; Prawepray, Nanthika; Paksornsit, Apiluk; Sitthipau, Thidadaow; Petchaithong, Sarayut; Jitsakulchaidejt, Raruay; Nookhai, Somboon; Lertpiriyasuwat, Cheewanan; Ongwandee, Sumet; Phanuphak, Praphan; Phanuphak, Nittaya

    2018-01-01

    Introduction:  Rapid diagnostic testing (RDT) for HIV has a quick turn-around time, which increases the proportion of people testing who receive their result. HIV RDT in Thailand has traditionally been performed only by medical technologists (MTs), which is a barrier to its being scaled up. We evaluated the performance of HIV RDT conducted by trained lay providers who were members of, or worked closely with, a group of men who have sex with men (MSM) and with transgender women (TG) communities, and compared it to tests conducted by MTs. Methods:  Lay providers received a 3-day intensive training course on how to perform a finger-prick blood collection and an HIV RDT as part of the Key Population-led Health Services (KPLHS) programme among MSM and TG. All the samples were tested by lay providers using Alere Determine HIV 1/2. HIV-reactive samples were confirmed by DoubleCheckGold Ultra HIV 1&2 and SD Bioline HIV 1/2. All HIV-positive and 10% of HIV-negative samples were re-tested by MTs using Serodia HIV 1/2. Results:  Of 1680 finger-prick blood samples collected and tested using HIV RDT by lay providers in six drop-in centres in Bangkok, Chiang Mai, Chonburi and Songkhla, 252 (15%) were HIV-positive. MTs re-tested these HIV-positive samples and 143 randomly selected HIV-negative samples with 100% concordant test results. Conclusion:  Lay providers in Thailand can be trained and empowered to perform HIV RDT as they were found to achieve comparable results in sample testing with MTs. Based on the task-shifting concept, this rapid HIV testing performed by lay providers as part of the KPLHS programme has great potential to enhance HIV prevention and treatment programmes among key at-risk populations.

  1. HIV/AIDS programmes should focus on improved access.

    Science.gov (United States)

    Manning, A

    2000-10-14

    This paper discusses the need for HIV/AIDS programs in sub-Saharan countries to focus more on improved access to information to empower poor people living in remote areas. It is noted that despite Glaxo Wellcome's move to reduce the cost of antiretroviral therapy, it is unlikely to have an impact on most of those infected with or affected by HIV/AIDS, since concerns regarding lack of sustainability, bureaucratic administration, and communication difficulties predominate in the country. In this regard, it is therefore recommended that national HIV/AIDS programs be balanced with the needs of both the community and the individual and in prevention and care. Health workers should be explicit in confronting traditional beliefs, such as those about gender roles and traditional medicine, in prevention campaigns. Moreover, there is also an urgent need to improve access to condoms; strengthen health programs such as directly observed treatment short-term (DOTS) courses for tuberculosis and the syndromic approach to sexually transmitted disease treatment; and improve practical support to communities caring for those who are sick and the orphans. Lastly, all partners working with prevention programs should use the more positive community attitudes towards HIV/AIDS issues seen in many sub-Saharan countries to develop evidence-based programs that focus more on improved access and less on sustainability.

  2. "Gender-specific HIV policies and programmes at South African ...

    African Journals Online (AJOL)

    HP27975994114

    2004-06-07

    Jun 7, 2004 ... will discuss employers' duties in the fight against HIV/AIDS with ..... The breach of the duty of care can also take the form of an omission.26 Brassey states: ... responsibility to the employer for the consequences of a negligent ...

  3. Evaluating 5 years' NIMART mentoring in South Africa's HIV treatment programme: Successes, challenges and future needs.

    Science.gov (United States)

    Jones, M; Cameron, D

    2017-09-22

    Task shifting has enabled South Africa (SA) to rapidly expand its HIV treatment programme. This has been achieved by training and mentoring primary-care nurses in nurse initiation and management of antiretroviral therapy (NIMART). Five years into its clinical mentoring programme, the Foundation for Professional Development conducted an evaluation that identified improved knowledge, attitudes and confidence perceived by nurses who received NIMART mentoring. Low completion rates for the Department of Health (DoH) NIMART training process were identified and therefore targeted mentoring was introduced; this increased the percentage of primary nurses eligible for DoH certificates of clinical competence in NIMART from 12%, adding a further 30%. There remain a large number of primary nurses who require mentoring in order to complete the NIMART process. For those who have completed the process, there remains a need for ongoing mentoring as SA's HIV programme evolves, complex cases emerge and primary care undergoes change.

  4. Integration of HIV and TB Services Results in Improved TB Treatment Outcomes and Earlier Prioritized ART Initiation in a Large Urban HIV Clinic in Uganda

    NARCIS (Netherlands)

    Hermans, Sabine M.; Castelnuovo, Barbara; Katabira, Catherine; Mbidde, Peter; Lange, Joep M. A.; Hoepelman, Andy I. M.; Coutinho, Alex; Manabe, Yukari C.

    2012-01-01

    Background: The World Health Organization recommends that treatment of tuberculosis (TB) in HIV-infected patients should be integrated with HIV care. In December 2008, a separate outdoor-integrated TB/HIV clinic was instituted for attendees of a large urban HIV clinic in Uganda. We sought to

  5. Understanding the drivers of interprofessional collaborative practice among HIV primary care providers and case managers in HIV care programmes.

    Science.gov (United States)

    Mavronicolas, Heather A; Laraque, Fabienne; Shankar, Arti; Campbell, Claudia

    2017-05-01

    Care coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.

  6. Boundaries of confidentiality in nursing care for mother and child in HIV programmes.

    Science.gov (United States)

    Våga, Bodil Bø; Moland, Karen Marie; Blystad, Astrid

    2016-08-01

    Confidentiality lies at the core of medical ethics and is the cornerstone for developing and keeping a trusting relationship between nurses and patients. In the wake of the HIV epidemic, there has been a heightened focus on confidentiality in healthcare contexts. Nurses' follow-up of HIV-positive women and their susceptible HIV-exposed children has proved to be challenging in this regard, but the ethical dilemmas concerning confidentiality that emerge in the process of ensuring HIV-free survival of the third party - the child - have attracted limited attention. The study explores challenges of confidentiality linked to a third party in nurse-patient relationships in a rural Tanzanian HIV/AIDS context. The study was carried out in rural and semi-urban settings of Tanzania where the population is largely agro-pastoral, the formal educational level is low and poverty is rife. The HIV prevalence of 1.5% is low compared to the national prevalence of 5.1%. Data were collected during 9 months of ethnographic fieldwork and consisted of participant observation in clinical settings and during home visits combined with in-depth interviews. The main categories of informants were nurses employed in prevention of mother-to-child transmission of HIV programmes and HIV-positive women enrolled in these programmes. Based on information about the study aims, all informants consented to participate. Ethical approval was granted by ethics review boards in Tanzania and Norway. The material indicates a delicate balance between the nurses' attempt to secure the HIV-free survival of the babies and the mothers' desire to preserve confidentiality. Profound confidentiality-related dilemmas emerged in actual practice, and indications of a lack of thorough consideration of the implication of a patient's restricted disclosure came to light during follow-up of the HIV-positive women and the third party - the child who is at risk of HIV infection through mother's milk. World Health Organization

  7. Abstinence And Faithfulness Programmes For Prevention Of Hiv ...

    African Journals Online (AJOL)

    Questions have been raised on whether abstinence and faithfulness programs work, particularly for young people. Research is needed for evidence-based documentation of the effectiveness or otherwise of abstinence and faithfulness programmes in young people. This review was conducted in three stages: identification ...

  8. Monitoring HIV Prevention Programme Outcomes among Key Populations in Kenya: Findings from a National Survey.

    Directory of Open Access Journals (Sweden)

    Parinita Bhattacharjee

    Full Text Available In preparation for the implementation of the Kenya AIDS Strategic Framework 2014/15-2018/19, the Kenya National AIDS and STI Control Programme facilitated a national polling booth survey as part of a baseline assessment of HIV-related risk behaviours among FSWs, MSM, and PWID, and their utilization of existing preventive interventions, as well as structural factors that may influence KPs' vulnerability to HIV. The survey was conducted among "key populations" (female sex workers, men who have sex with men, and people who inject drugs to understand current HIV risk and prevention behaviours, utilization of existing programmes and services, and experiences of violence. In total, 3,448 female sex workers, 1,308 men who have sex with men, and 690 people who inject drugs were randomly selected to participate in polling booth survey sessions from seven priority sites. Survey responses were aggregated and descriptive statistics derived. In general, reported condom use among all key populations was quite high with paying clients, and lower with regular, non-paying partners. Many participants reported unavailability of condoms or clean injecting equipment within the past month. Exposure to, and utilization of, existing HIV prevention services varied significantly among the groups, and was reported least commonly by female sex workers. Encouragingly, approximately three-quarters of all key population members reported receiving an HIV test in the past three months. All key population groups reported experiencing high levels of physical and sexual violence from partners/clients, and/or arrest and violence by law enforcement officials. Although some of the findings are encouraging, there is room for improvement in HIV prevention programmes and services for key populations across Kenya.

  9. HIV care continuum in Rwanda: a cross-sectional analysis of the national programme.

    Science.gov (United States)

    Nsanzimana, Sabin; Kanters, Steve; Remera, Eric; Forrest, Jamie I; Binagwaho, Agnes; Condo, Jeanine; Mills, Edward J

    2015-05-01

    Rwanda has made remarkable progress towards HIV care programme with strong national monitoring and surveillance. Knowledge about the HIV care continuum model can help to improve outcomes in patients. We aimed to quantify engagement, mortality, and loss to follow-up of patients along the HIV care continuum in Rwanda in 2013. We collated data for individuals with HIV who participated in the national HIV care programme in Rwanda and calculated the numbers of individuals or proportions of the population at each stage and the transition probabilities between stages of the continuum. We calculated factors associated with mortality and loss to follow-up by fitting Cox proportional hazards regression models, one for the stage of care before antiretroviral therapy (ART) initiation and another for stage of care during ART. An estimated 204,899 individuals were HIV-positive in Rwanda in 2013. Among these individuals, 176,174 (86%) were in pre-ART or in ART stages and 129,405 (63%) had initiated ART by the end of 2013. 82·1% (95% CI 80·7-83·4) of patients with viral load measurements (n=3066) were virally suppressed (translating to 106,371 individuals or 52% of HIV-positive individuals). Mortality was 0·6% (304 patients) in the pre-ART stage and 1·0% (1255 patients) in the ART stage; 2247 (3·9%) patients were lost to follow-up in pre-ART stage and 2847 (2·2%) lost in ART stage. Risk factors for mortality among patients in both pre-ART and ART stages included older age, CD4 cell count at initiation, and male sex. Risk factors for loss to follow-up among patients at both pre-ART and ART stages included younger age (age 10-29 year) and male sex. The HIV care continuum is a multitrajectory pathway in which patients have many opportunities to leave and re-engage in care. Knowledge about the points at which individuals are most likely to leave care could improve large-scale delivery of HIV programmes. The Bill & Melinda Gates Foundation. Copyright © 2015 Elsevier Ltd. All

  10. The tuberculosis challenge in a rural South African HIV programme

    Directory of Open Access Journals (Sweden)

    Cooke Graham S

    2010-02-01

    Full Text Available Abstract Background South Africa remains the country with the greatest burden of HIV-infected individuals and the second highest estimated TB incidence per capita worldwide. Within South Africa, KwaZulu-Natal has one of the highest rates of TB incidence and an emerging epidemic of drug-resistant tuberculosis. Methods Review of records of consecutive HIV-infected people initiated onto ART between 1st January 2005 and 31st March 2006. Patients were screened for TB at initiation and incident episodes recorded. CD4 counts, viral loads and follow-up status were recorded; data was censored on 5th August 2008. Geographic cluster analysis was performed using spatial scanning. Results 801 patients were initiated. TB prevalence was 25.3%, associated with lower CD4 (AHR 2.61 p = 0.01 for CD4 25 copies/ml (OR 1.75 p = 0.11. A low-risk cluster for incident TB was identified for patients living near the local hospital in the geospatial analysis. Conclusion There is a large burden of TB in this population. Rate of incident TB stabilises at a rate higher than that of the overall population. These data highlight the need for greater research on strategies for active case finding in rural settings and the need to focus on strengthening primary health care.

  11. Medication therapy management services in community pharmacy: a pilot programme in HIV specialty pharmacies.

    Science.gov (United States)

    Rosenquist, Ashley; Best, Brookie M; Miller, Teresa A; Gilmer, Todd P; Hirsch, Jan D

    2010-12-01

    Pharmacist-provided medication therapy management services (MTMS) have been shown to increase patient's adherence to medications, improve health outcomes and reduce overall medical costs. The purpose of this study was to describe a pilot programme that provided pharmacy-based MTMS for patients with HIV/AIDS in the state of California, USA. Pharmacists from the 10 pilot pharmacies were surveyed using an online data collection tool. Information was collected to describe the types of MTMS offered, proportion of patients actively using specific MTMS, pharmacist beliefs regarding effect on patient outcomes and barriers to providing MTMS, ability to offer MTMS without pilot programme funding and specialized pharmacist or staff training. Each responding pharmacy (7 of 10) varied in the number of HIV/AIDS patients served and prescription volume. All pharmacists had completed HIV/AIDS-related continuing education programmes, and some had other advanced training. The type of MTMS being offered varied at each pharmacy with 'individualized counselling by a pharmacist when overuse or underuse was detected' and 'refill reminders by telephone' being actively used by the largest proportion of patients. Most, but not all, pharmacists cited reimbursement as a barrier to MTMS provision. Pharmacists believed the MTMS they provide resulted in improved satisfaction (patient and provider), medication usage, therapeutics response and patient quality of life. The type of MTMS offered, and proportion of patients actively using, varied among participating pilot pharmacies. © 2010 Blackwell Publishing Ltd.

  12. Estimating the Cost-Effectiveness of HIV Prevention Programmes in Vietnam, 2006-2010: A Modelling Study.

    Directory of Open Access Journals (Sweden)

    Quang Duy Pham

    Full Text Available Vietnam has been largely reliant on international support in its HIV response. Over 2006-2010, a total of US$480 million was invested in its HIV programmes, more than 70% of which came from international sources. This study investigates the potential epidemiological impacts of these programmes and their cost-effectiveness.We conducted a data synthesis of HIV programming, spending, epidemiological, and clinical outcomes. Counterfactual scenarios were defined based on assumed programme coverage and behaviours had the programmes not been implemented. An epidemiological model, calibrated to reflect the actual epidemiological trends, was used to estimate plausible ranges of programme impacts. The model was then used to estimate the costs per averted infection, death, and disability adjusted life-year (DALY.Based on observed prevalence reductions amongst most population groups, and plausible counterfactuals, modelling suggested that antiretroviral therapy (ART and prevention programmes over 2006-2010 have averted an estimated 50,600 [95% uncertainty bound: 36,300-68,900] new infections and 42,600 [36,100-54,100] deaths, resulting in 401,600 [312,200-496,300] fewer DALYs across all population groups. HIV programmes in Vietnam have cost an estimated US$1,972 [1,447-2,747], US$2,344 [1,843-2,765], and US$248 [201-319] for each averted infection, death, and DALY, respectively.Our evaluation suggests that HIV programmes in Vietnam have most likely had benefits that are cost-effective. ART and direct HIV prevention were the most cost-effective interventions in reducing HIV disease burden.

  13. Estimating the Cost-Effectiveness of HIV Prevention Programmes in Vietnam, 2006-2010: A Modelling Study

    Science.gov (United States)

    Pham, Quang Duy; Wilson, David P.; Kerr, Cliff C.; Shattock, Andrew J.; Do, Hoa Mai; Duong, Anh Thuy; Nguyen, Long Thanh; Zhang, Lei

    2015-01-01

    Introduction Vietnam has been largely reliant on international support in its HIV response. Over 2006-2010, a total of US$480 million was invested in its HIV programmes, more than 70% of which came from international sources. This study investigates the potential epidemiological impacts of these programmes and their cost-effectiveness. Methods We conducted a data synthesis of HIV programming, spending, epidemiological, and clinical outcomes. Counterfactual scenarios were defined based on assumed programme coverage and behaviours had the programmes not been implemented. An epidemiological model, calibrated to reflect the actual epidemiological trends, was used to estimate plausible ranges of programme impacts. The model was then used to estimate the costs per averted infection, death, and disability adjusted life-year (DALY). Results Based on observed prevalence reductions amongst most population groups, and plausible counterfactuals, modelling suggested that antiretroviral therapy (ART) and prevention programmes over 2006-2010 have averted an estimated 50,600 [95% uncertainty bound: 36,300–68,900] new infections and 42,600 [36,100–54,100] deaths, resulting in 401,600 [312,200–496,300] fewer DALYs across all population groups. HIV programmes in Vietnam have cost an estimated US$1,972 [1,447–2,747], US$2,344 [1,843–2,765], and US$248 [201–319] for each averted infection, death, and DALY, respectively. Conclusions Our evaluation suggests that HIV programmes in Vietnam have most likely had benefits that are cost-effective. ART and direct HIV prevention were the most cost-effective interventions in reducing HIV disease burden. PMID:26196290

  14. An HIV/AIDS intervention programme with Buddhist aid in Yunnan Province.

    Science.gov (United States)

    Wu, Feng; Zhang, Kong-lai; Shan, Guang-liang

    2010-04-20

    The prevalence of HIV/AIDS in Chinese ethnic minorities is an important component of China's AIDS issues. In this study, we launched an intervention programme in Yunnan Province of China, where the Dai people live, to carry out the community-based HIV/AIDS health education and behavioral interventions on ordinary Dai farmers. The Dai people believe in Theravada Buddhism. Four rural communities were randomly divided into two groups. In one group (Buddhist group), HIV/AIDS health education and behavioral intervention were carried out by monks. The other group (women group) was instructed by women volunteers. The intervention continued for one year and the data were collected before and after the intervention project. In the Buddhist group, the villagers' AIDS related knowledge score was boosted from 3.11 to 3.65 (P Buddhist group, the villager's attitude score towards the people living with HIV and AIDS (PLWHA) also increased significantly from 1.51 to 2.16 (P Buddhist organization has limited success in promoting the use of condoms, but plays an important role in eliminating HIV/AIDS related discrimination.

  15. Evidence-based approach to HIV/AIDS policy and research prioritization in the Islamic Republic of Iran.

    Science.gov (United States)

    Feizzadeh, A; Nedjat, S; Asghari, S; Keshtkar, A; Heshmat, R; Setayesh, H; Majdzadeh, R

    2010-03-01

    In formulating the second national strategic plan for prevention of HIV/AIDS in the Islamic Republic of Iran a more evidence-based approach was needed. This paper reports on a systematic review of the local evidence about the determinants of HIV/AIDS transmission in 3 categories: poor knowledge and negative attitudes about HIV transmission; injection drug use; and sexual promiscuity. Of 93 reports reviewed, 53 met the inclusion criteria. Information about the prevalence and magnitude of effect for the 3 risk determinants at the national and regional level was scarce. Heterogeneity between studies, even in the same sub-population, was significant. An improved research base and better sharing of information are needed within countries of the Eastern Mediterranean Region.

  16. Development and formative evaluation of a family-centred adolescent HIV prevention programme in South Africa.

    Science.gov (United States)

    Visser, Maretha; Thurman, Tonya R; Spyrelis, Alexandra; Taylor, Tory M; Nice, Johanna K; Finestone, Michelle

    2018-03-06

    Preventing HIV among young people is critical to achieving and sustaining global epidemic control. Evidence from Western settings suggests that family-centred prevention interventions may be associated with greater reductions in risk behaviour than standard adolescent-only models. Despite this, family-centred models for adolescent HIV prevention are nearly non-existent in South Africa - home to more people living with HIV than any other country. This paper describes the development and formative evaluation of one such intervention: an evidence-informed, locally relevant, adolescent prevention intervention engaging caregivers as co-participants. The programme, originally consisting of 19 sessions for caregivers and 14 for adolescents, was piloted with 12 groups of caregiver-adolescent dyads by community-based organizations (CBOs) in KwaZulu-Natal and Gauteng provinces. Literature and expert reviews were employed in the development process, and evaluation methods included analysis of attendance records, session-level fidelity checklists and facilitator feedback forms collected during the programme pilot. Facilitator focus group discussions and an implementer programme workshop were also held. Results highlighted the need to enhance training content related to cognitive behavioural theory and group management techniques, as well as increase the cultural relevance of activities in the curriculum. Participant attendance challenges were also identified, leading to a shortened and simplified session set. Findings overall were used to finalize materials and guidance for a revised 14-week group programme consisting of individual and joint sessions for adolescents and their caregivers, which may be implemented by community-based facilitators in other settings. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. Preliminary evaluation of the impact of a Web-based HIV testing programme in Abruzzo Region on the prevention of late HIV presentation and associated mortality.

    Science.gov (United States)

    Polilli, Ennio; Sozio, Federica; Di Stefano, Paola; Clerico, Luigi; Di Iorio, Giancarlo; Parruti, Giustino

    2018-04-01

    This study aimed to analyze the efficacy of a Web-based testing programme in terms of the prevention of late HIV presentation. The clinical characteristics of patients diagnosed with HIV via the Web-based testing programme were compared to those of patients diagnosed in parallel via standard diagnostic care procedures. This study included the clinical and demographic data of newly diagnosed HIV patients enrolled at the study clinic between February 2014 and June 2017. These patients were diagnosed either via standard diagnostic procedures or as a result of the Web-based testing programme. Eighty-eight new cases of HIV were consecutively enrolled; their mean age was 39.1±13.0 years. Fifty-nine patients (67%) were diagnosed through standard diagnostic procedures and 29 (33%) patients came from the Web-based testing programme. Late presentation (62% vs. 34%, p=0.01) and AIDS-defining conditions at presentation (13 vs. 1, p=0.02) were significantly more frequent in the standard care group than in the Web-based group; four of 13 patients with AIDS diagnosed under standard diagnostic procedures died, versus none in the Web-based testing group (pWeb-based recruitment for voluntary and free HIV testing helped to diagnose patients with less advanced HIV disease and no risk of death, from all at-risk groups, in comparison with standard care testing. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Integration of HIV and TB services results in improved TB treatment outcomes and earlier prioritized ART initiation in a large urban HIV clinic in Uganda.

    Science.gov (United States)

    Hermans, Sabine M; Castelnuovo, Barbara; Katabira, Catherine; Mbidde, Peter; Lange, Joep M A; Hoepelman, Andy I M; Coutinho, Alex; Manabe, Yukari C

    2012-06-01

    The World Health Organization recommends that treatment of tuberculosis (TB) in HIV-infected patients should be integrated with HIV care. In December 2008, a separate outdoor-integrated TB/HIV clinic was instituted for attendees of a large urban HIV clinic in Uganda. We sought to evaluate associated TB and HIV treatment outcomes. Routinely collected clinical, pharmacy, and laboratory data were merged with TB clinic data for patients initiating TB treatment in 2009 and with TB register data for patients in 2007. TB treatment outcomes and (timing of) antiretroviral therapy (ART) initiation in ART-naive patients [overall and stratified by CD4+ T cell (CD4) count] in 2007 and 2009 were compared. Nosocomial transmission rates could not be assessed. Three hundred forty-six patients were initiated on TB treatment in 2007 and 366 in 2009. Median CD4 counts at TB diagnosis did not differ. TB treatment cure or completion increased from 62% to 68%, death or default decreased from 33% to 25% (P ART-naive TB patients were initiated on ART in 2009 versus 2007 (57% and 66%, P = 0.031), but this decrease was only in patients with CD4 counts >250 cells per cubic millimeter (19% vs. 48%, P = 0.003). More patients were started on ART during TB treatment (94% vs. 78%, P ART initiation. This supports rollout of a fully integrated TB/HIV service delivery model throughout high-prevalence TB and HIV settings.

  19. The convergence of American and Nigerian religious conservatism in a biopolitical shaping of Nigeria's HIV/AIDS prevention programmes.

    Science.gov (United States)

    Jappah, Jlateh V

    2013-01-01

    Nigeria has the largest number of HIV/AIDS cases in West Africa, with 3.3 million people estimated to be living with the disease. The country remains a fragile democratic state and has allocated insufficient resources to combat the spread of HIV/AIDS among its citizens. The preponderance of President's Emergency Plan for AIDS Relief (PEPFAR) dollars, expert knowledge, conservative ideology and activities has shaped the direction of HIV/AIDS sexual-transmission prevention programmes in Nigeria. PEPFAR channels significant resources through Nigerian faith-based organisations (FBOs), and considers these organisations integral for HIV prevention strategies. In many instances, HIV/AIDS prevention programmes managed by FBOs reflect their ideologies of morality and sexuality. There is a convergence of religious ideology concerning morality and HIV infectivity between American and Nigerian conservatives; this produces a fertile ground for the influence and expansion of the conservative activities of PEPFAR in Nigeria. The paper highlights this nexus and draws attention to the biopolitical underpinning of PEPFAR in shaping Nigeria's HIV prevention programmes. The paper further notes both positive and negative effects of PEPFAR activities and attempts by the Obama administration to redirect PEPFAR to a more holistic approach in order to optimise outcomes.

  20. Challenges faced by health workers in implementing the prevention of mother-to-child HIV transmission (PMTCT) programme in Uganda.

    Science.gov (United States)

    Nuwagaba-Biribonwoha, H; Mayon-White, R T; Okong, P; Carpenter, L M

    2007-09-01

    To report the experience of health workers who had played key roles in the early stages of implementing the prevention of mother-to-child HIV transmission services (PMTCT) in Uganda. Interviews were conducted with 15 key informants including counsellors, obstetricians and PMTCT coordinators at the five PMTCT test sites in Uganda to investigate the benefits, challenges and sustainability of the PMTCT programme. Audio-taped interviews were held with each informant between January and June 2003. These were transcribed verbatim and manually analysed using the framework approach. The perceived benefits reported by informants were improvement of general obstetric care, provision of antiretroviral prophylaxis for HIV-positive mothers, staff training and community awareness. The main challenges lay in the reluctance of women to be tested for HIV, incomplete follow-up of participants, non-disclosure of HIV status and difficulties with infant feeding for HIV-positive mothers. Key informants thought that the programme's sustainability depended on maintaining staff morale and numbers, on improving services and providing more resources, particularly antiretroviral therapy for the HIV-positive women and their families. Uganda's experience in piloting the PMTCT programme reflected the many challenges faced by health workers. Potentially resource-sparing strategies such as the 'opt-out' approach to HIV testing required further evaluation.

  1. Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa

    Directory of Open Access Journals (Sweden)

    Essack Zaynab

    2010-03-01

    Full Text Available Abstract Background Africa continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in developing countries, or in populations affected by all three diseases, is likely to result in numerous ethical challenges. Methods In order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009. Results Key cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing. Conclusion The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields.

  2. Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa.

    Science.gov (United States)

    Mamotte, Nicole; Wassenaar, Douglas; Koen, Jennifer; Essack, Zaynab

    2010-03-09

    Africa continues to bear a disproportionate share of the global HIV/AIDS, tuberculosis (TB) and malaria burden. The development and distribution of safe, effective and affordable vaccines is critical to reduce these epidemics. However, conducting HIV/AIDS, TB, and/or malaria vaccine trials simultaneously in developing countries, or in populations affected by all three diseases, is likely to result in numerous ethical challenges. In order to explore convergent ethical issues in HIV/AIDS, TB and malaria vaccine trials in Africa, the Ethics, Law and Human Rights Collaborating Centre of the WHO/UNAIDS African AIDS Vaccine Programme hosted a consultation on the Convergent Ethical Issues in HIV/AIDS, TB and Malaria Vaccine Trials in Africa in Durban, South Africa on the 10-11 February 2009. Key cross cutting ethical issues were prioritized during the consultation as community engagement; ancillary care obligations; care and treatment; informed consent; and resource sharing. The consultation revealed that while there have been few attempts to find convergence on ethical issues between HIV/AIDS, TB and malaria vaccine trial fields to date, there is much common ground and scope for convergence work between stakeholders in the three fields.

  3. Preliminary evaluation of the impact of a Web-based HIV testing programme in Abruzzo Region on the prevention of late HIV presentation and associated mortality

    Directory of Open Access Journals (Sweden)

    Ennio Polilli

    2018-04-01

    Full Text Available Objective: This study aimed to analyze the efficacy of a Web-based testing programme in terms of the prevention of late HIV presentation. The clinical characteristics of patients diagnosed with HIV via the Web-based testing programme were compared to those of patients diagnosed in parallel via standard diagnostic care procedures. Methods: This study included the clinical and demographic data of newly diagnosed HIV patients enrolled at the study clinic between February 2014 and June 2017. These patients were diagnosed either via standard diagnostic procedures or as a result of the Web-based testing programme. Results: Eighty-eight new cases of HIV were consecutively enrolled; their mean age was 39.1 ± 13.0 years. Fifty-nine patients (67% were diagnosed through standard diagnostic procedures and 29 (33% patients came from the Web-based testing programme. Late presentation (62% vs. 34%, p = 0.01 and AIDS-defining conditions at presentation (13 vs. 1, p = 0.02 were significantly more frequent in the standard care group than in the Web-based group; four of 13 patients with AIDS diagnosed under standard diagnostic procedures died, versus none in the Web-based testing group (p < 0.001. Conclusions: Web-based recruitment for voluntary and free HIV testing helped to diagnose patients with less advanced HIV disease and no risk of death, from all at-risk groups, in comparison with standard care testing. Keywords: AIDS, HIV, Late presentation, Voluntary and free testing, HIV diagnosis, Sexually transmitted infections

  4. Manual for the classification and prioritization of risks due to major accidents in process and related industries. Inter-Agency programme on the assessment and management of health and environmental risks from energy and other complex industrial systems

    International Nuclear Information System (INIS)

    1996-11-01

    The IAEA, the United Nations Environment Programme (UNEP), the United Nations Industrial Development Organization (UNIDO) and the World Health Organization (WHO) decided in 1986 to join forces in order to promote the use of integrated areas wide approaches to risk management. The Inter-Agency Programme brings together expertise in health, the environment, industry and energy, all vital for effective risk management. The purpose of the Inter-Agency Programme is to develop a broad approach to the identification, prioritization and minimization of industrial hazards in a given geographical area. This is one of a series of publications intended to be issued on behalf of the four participating UN organizations. This is the first revision of the original report, distributed in December 1993. The revision was undertaken in the light of experience with the original edition and was prompted by the wish to add the results of a practical case study and some new developments. 13 figs, 23 tabs

  5. The evaluation of a rapid in situ HIV confirmation test in a programme with a high failure rate of the WHO HIV two-test diagnostic algorithm.

    Directory of Open Access Journals (Sweden)

    Derryck B Klarkowski

    Full Text Available BACKGROUND: Concerns about false-positive HIV results led to a review of testing procedures used in a Médecins Sans Frontières (MSF HIV programme in Bukavu, eastern Democratic Republic of Congo. In addition to the WHO HIV rapid diagnostic test algorithm (RDT (two positive RDTs alone for HIV diagnosis used in voluntary counselling and testing (VCT sites we evaluated in situ a practical field-based confirmation test against western blot WB. In addition, we aimed to determine the false-positive rate of the WHO two-test algorithm compared with our adapted protocol including confirmation testing, and whether weakly reactive compared with strongly reactive rapid test results were more likely to be false positives. METHODOLOGY/PRINCIPAL FINDINGS: 2864 clients presenting to MSF VCT centres in Bukavu during January to May 2006 were tested using Determine HIV-1/2 and UniGold HIV rapid tests in parallel by nurse counsellors. Plasma samples on 229 clients confirmed as double RDT positive by laboratory retesting were further tested using both WB and the Orgenics Immunocomb Combfirm HIV confirmation test (OIC-HIV. Of these, 24 samples were negative or indeterminate by WB representing a false-positive rate of the WHO two-test algorithm of 10.5% (95%CI 6.6-15.2. 17 of the 229 samples were weakly positive on rapid testing and all were negative or indeterminate by WB. The false-positive rate fell to 3.3% (95%CI 1.3-6.7 when only strong-positive rapid test results were considered. Agreement between OIC-HIV and WB was 99.1% (95%CI 96.9-99.9% with no false OIC-HIV positives if stringent criteria for positive OIC-HIV diagnoses were used. CONCLUSIONS: The WHO HIV two-test diagnostic algorithm produced an unacceptably high level of false-positive diagnoses in our setting, especially if results were weakly positive. The most probable causes of the false-positive results were serological cross-reactivity or non-specific immune reactivity. Our findings show that the OIC-HIV

  6. Implementation of prevention of mother-to-child transmission of HIV programme through private hospitals of Delhi--policy implications.

    Science.gov (United States)

    Gupta, A K; Garg, C R; Joshi, B C; Rawat, N; Dabla, V; Gupta, A

    2015-01-01

    In India, programme for prevention of mother-to-child transmission (PMTCT) of HIV is primarily implemented through public health system. State AIDS Control Societies (SACSs) encourage private hospitals to set up integrated counselling and testing centres (ICTCs). However, private hospitals of Delhi did not set up ICTCs. Consequently, there is no information on PMTCT interventions in private hospitals of Delhi. This study was undertaken by Delhi SACS during March 2013 through September 2013 to assess status of implementation of PMTCT programme in various private hospitals of Delhi to assist programme managers in framing national policy to facilitate uniform implementation of National PMTCT guidelines. Out of total 575 private hospitals registered with Government of Delhi, 336 (58.4%) catering to pregnant women were identified. About 100 private hospitals with facility of antenatal care, vaginal/caesarean delivery and postnatal care and minimum 10 indoor beds were selected for study. Study sample comprised of large corporate hospitals (≥100 beds; n = 29), medium-sized hospitals (25 to women tested, 52 (0.14%) were detected HIV-positive. However, against National Policy, HIV testing was done without pre/post-test counselling/or consent of women, no PMTCT protocol existed, delivery of HIV-positive women was not undertaken and no efforts were made to link HIV-positive women to antiretroviral treatment. Major intervention observed was medical termination of pregnancy, which indicates lack of awareness in private hospitals about available interventions under national programme. The role of private hospitals in management of HIV in pregnant women must be recognized and mainstreamed in HIV control efforts. There is an urgent need for capacity building of private health care providers to improve standards of practice. National AIDS Control Organization may consider establishing linkages or adopting model developed by some countries with generalized epidemic for delivering

  7. Programme

    OpenAIRE

    Hobday, E, fl. 1905, artist

    2003-01-01

    A photograph of an illustrated programme listing dances. The illustration shows a snake charmer playing to a snake while another man watches. Buildings and trees can be seen behind a wall in the distance. In the lower right-hand corner of the programme is the signature 'E. Hobday'. The programme is almost certainly related to the Punjab Ball, Lahore. It is placed next to the Punjab Ball Menu in the album and the Menu is also illustrated by 'E. Hobday'.

  8. Prevalence of malnutrition among HIV-infected children in Central and West-African HIV-care programmes supported by the Growing Up Programme in 2011: a cross-sectional study.

    Science.gov (United States)

    Jesson, Julie; Masson, David; Adonon, Arsène; Tran, Caroline; Habarugira, Capitoline; Zio, Réjane; Nicimpaye, Léoncie; Desmonde, Sophie; Serurakuba, Goreth; Kwayep, Rosine; Sare, Edith; Konate, Tiefing; Nimaga, Abdoulaye; Saina, Philemon; Kpade, Akossiwa; Bassuka, Andrée; Gougouyor, Gustave; Leroy, Valériane

    2015-05-26

    The burden of malnutrition among HIV-infected children is not well described in sub-Saharan Africa, even though it is an important problem to take into account to guarantee appropriate healthcare for these children. We assessed the prevalence of malnutrition and its associated factors among HIV-infected children in HIV care programmes in Central and West-Africa. A cross-sectional study was conducted from September to December 2011 among the active files of HIV-infected children aged 2-19 years old, enrolled in HIV-care programmes supported by the Sidaction Growing Up Programme in Benin, Burundi, Cameroon, Côte d'Ivoire, Mali, Chad and Togo. Socio-demographics characteristics, anthropometric, clinical data, and nutritional support were collected. Anthropometric indicators, expressed in Z-scores, were used to define malnutrition: Height-for-age (HAZ), Weight-for-Height (WHZ) for children children ≥5 years. Three types of malnutrition were defined: acute malnutrition (WHZ/BAZ malnutrition (HAZ malnutrition (WHZ/BAZ malnutrition. Overall, 1350 HIV-infected children were included; their median age was 10 years (interquartile range [IQR]: 7-13 years), 49 % were girls. 80 % were on antiretroviral treatment (ART), for a median time of 36 months. The prevalence of malnutrition was 42 % (95 % confidence interval [95% CI]: 40-44 %) with acute, chronic and mixed malnutrition at 9 % (95% CI: 6-12 %), 26 % (95% CI: 23-28 %), and 7 % (95% CI: 5-10 %), respectively. Among those malnourished, more than half of children didn't receive any nutritional support at the time of the survey. Acute malnutrition was associated with male gender, severe immunodeficiency, and the absence of ART; chronic malnutrition with male gender and age (malnutrition with male gender, age (malnutrition. The prevalence of malnutrition in HIV-infected children even on ART remains high in HIV care programmes. Anthropometric measurements and appropriate nutritional care of malnourished HIV

  9. Workplace programmes for HIV and tuberculosis: a systematic review to support development of international guidelines for the health workforce.

    Science.gov (United States)

    Yassi, Annalee; O'Hara, Lyndsay M; Lockhart, Karen; Spiegel, Jerry M

    2013-01-01

    The health service sector has a vital role to play in delivering human immunodeficiency virus (HIV) and tuberculosis (TB) prevention, treatment and care, yet evidence indicates that healthcare workers (HCWs) themselves lack adequate access to HIV and TB services. HCWs are also at increased risk from TB and other infectious diseases at work, and therefore accessing HIV services is particularly important. A systematic review was therefore conducted to inform the development of World Health Organization (WHO) guidelines to improve access to HIV and TB services, and specifically, to assess the evidence regarding providing such services through workplace-based programmes. We identified any study published since 1984 that addressed outcomes of interest as defined through multi-stakeholder consultations, and were related to workplace interventions in (1) the healthcare workplace and (2) any workplace that included HIV and/or TB diagnosis and/or treatment. Interventions focusing solely on primary prevention with no diagnostic or treatment services were excluded, as they were the subject of other guidelines. A minimum of two reviewers independently extracted data and assessed the articles against pre-set selection criteria; studies were also profiled and quality assessed by a minimum of two reviewers. Three studies met these criteria specifically for HCWs; all showed a preponderance of positive benefits, with minimal negative outcome. Seven studies met these criteria regarding workplace HIV and/or TB diagnosis and/or treatment from other sectors, public or private. Again, all showed positive results. The paucity of high-quality evidence in this field of research was itself an important finding, beckoning further research on workplace-based programmes for health workers. Nonetheless, while more well-designed intervention studies are definitely desirable, providing programmes for HCWs to obtain HIV and TB diagnosis and treatment at the workplace is supported by the literature

  10. HIV epidemic appraisals for assisting in the design of effective prevention programmes: shifting the paradigm back to basics.

    Directory of Open Access Journals (Sweden)

    Sharmistha Mishra

    Full Text Available To design HIV prevention programmes, it is critical to understand the temporal and geographic aspects of the local epidemic and to address the key behaviours that drive HIV transmission. Two methods have been developed to appraise HIV epidemics and guide prevention strategies. The numerical proxy method classifies epidemics based on current HIV prevalence thresholds. The Modes of Transmission (MOT model estimates the distribution of incidence over one year among risk-groups. Both methods focus on the current state of an epidemic and provide short-term metrics which may not capture the epidemiologic drivers. Through a detailed analysis of country and sub-national data, we explore the limitations of the two traditional methods and propose an alternative approach.We compared outputs of the traditional methods in five countries for which results were published, and applied the numeric and MOT model to India and six districts within India. We discovered three limitations of the current methods for epidemic appraisal: (1 their results failed to identify the key behaviours that drive the epidemic; (2 they were difficult to apply to local epidemics with heterogeneity across district-level administrative units; and (3 the MOT model was highly sensitive to input parameters, many of which required extraction from non-regional sources. We developed an alternative decision-tree framework for HIV epidemic appraisals, based on a qualitative understanding of epidemiologic drivers, and demonstrated its applicability in India. The alternative framework offered a logical algorithm to characterize epidemics; it required minimal but key data.Traditional appraisals that utilize the distribution of prevalent and incident HIV infections in the short-term could misguide prevention priorities and potentially impede efforts to halt the trajectory of the HIV epidemic. An approach that characterizes local transmission dynamics provides a potentially more effective tool with

  11. The effects of a 16-week aerobic exercise programme on cognitive function in people living with HIV.

    Science.gov (United States)

    McDermott, Adam; Zaporojan, Lilia; McNamara, Patricia; Doherty, Colin P; Redmond, Janice; Forde, Cuisle; Gormley, John; Egaña, Mikel; Bergin, Colm

    2017-06-01

    High levels of cardiovascular fitness and physical activity are associated with higher levels of cognitive function in people with HIV, thus, they may reduce the risk of developing HIV-associated neurocognitive disorder (HAND). This study aimed to investigate the effects of a 16-week aerobic exercise intervention on cognitive function in people with HIV. Eleven participants living with HIV were recruited into the study. Participants were randomised into either an exercise group (n = 5), that completed a 16-week aerobic exercise programme training, 3 times per week (2 supervised sessions and one unsupervised session) or a control group (n = 6) that received no intervention. Outcomes measured included cognitive function (Montreal cognitive assessment (MOCA) and the Trail making tests A and B), aerobic fitness (modified Bruce protocol), sleep quality (Pittsburgh sleep quality index; PSQI) and physical activity levels (seven-day accelerometry). At baseline, higher levels of moderate physical activity were positively correlated with higher MOCA scores and levels of aerobic fitness were negatively associated with Trail A scores (P = 0.04 and P = 0.001 respectively). However, exercise training did not induce any significant improvements in cognitive function or aerobic fitness. The overall mean adherence rate to the exercise programme was 60%. In conclusion, in the present study a 16-week aerobic exercise intervention did not affect the cognitive function of participants with HIV. It is likely that longer intervention periods and/or higher adherence rates to exercise might be needed for an aerobic exercise programme to be effective in improving cognitive function in a cohort with no baseline cognitive impairments.

  12. Patterns of disclosure and antiretroviral treatment adherence in a South African mining workplace programme and implications for HIV prevention.

    Science.gov (United States)

    Bhagwanjee, Anil; Govender, Kaymarlin; Akintola, Olagoke; Petersen, Inge; George, Gavin; Johnstone, Leigh; Naidoo, Kerisha

    2011-01-01

    Social and psychological barriers to the disclosure of one's seropositive HIV status to significant others and poor adherence to taking medications pose significant challenges to the scaling-up of access to antiretroviral treatment (ART) in the workplace. Such barriers are predictive of sub-optimal treatment outcomes and bedevil HIV-prevention interventions at a societal level. Against this background, this article explores the lived experiences of 19 HIV-positive male participants, between the ages of 33 and 57 years, who were enrolled in an ART programme managed at an occupational health clinic at a mining company in South Africa. The majority of these mineworkers had been aware of their HIV status for between 5 and 7 years. The study explored psychological and relational factors, as aspects of these participants lived experiences, which had a bearing on their adherence to their ART regimen and the disclosure choices that they made regarding their HIV status. In our sample, those participants who were adherent demonstrated higher levels of control and acceptance of their HIV infection and were more confident in their ability to manage their treatment, while the group who were non-adherent presented with lower levels of adherence motivation and self-efficacy, difficulties in maintaining a healthy lifestyle and significant challenges in maintaining control over their lives. While most of the men favoured disclosing their HIV status to their partners for the sake of treatment support, they were less sure about disclosing to family members and non-family members, respectively, because of their need to protect these persons and due to their fear of being stigmatised. It was evident that treatment adherence choices and behaviours were impacted by psychological and relational factors, including disclosure decisions. We conclude with a bivariate model for understanding the adherence behaviours that influenced different patterns of ART adherence among the sample, and

  13. Assessing behavioural intention of small and medium enterprises in implementing an HIV/AIDS policy and programme

    Directory of Open Access Journals (Sweden)

    A. Parsadh

    2005-10-01

    Full Text Available Small and Medium Enterprises (SMEs are likely to feel the impact of an HIV/AIDS epidemic through reduced productivity and an increased percentage of absenteeism; staff turnover; recruitment and training costs; cost of employee benefits; and poor staff morale. One of the interventions is to implement an HIV/AIDS policy and programme, yet a literature search showed that psychological studies of SMEs in implementing an HIV/AIDS policy and programme are limited. The present study utilised the model of the theory of planned behaviour (Ajzen, 1988, 1991, which is an extension of the theory of reasoned action (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980. The intention to implement an HIV/AIDS policy and programme was predicted by the theory of planned behaviour constructs such as attitude, subjective norm and perceived behavioural control. The theory of planned behaviour was found to have limited use in assessing behavioural intention of SMEs in implementing an HIV/AIDS policy and programme. Opsomming Die uitwerking van die MIV/VIGS pandemie op Klein en Medium Sake-ondernemings sal tot gevolg hê ’n afname in produktiwiteit; ’n toename in personeelafwesigheid, personeelomset, personeelwerwing en –opleidingskoste, personeelvoordele; en swak personeel moraal tot gevolg hê. Een manier om die probleem aan te spreek is om ’n MIV/VIGS beleid en program te implimenteer. Navorsing toon dat psigologiese studies van klein en medium sakeondernemings om ’n HIV/VIGS beleid en program te implimenteer, beperk is. Hierdie navorsing steun op die teorie van planmatige gedrag (Ajzen, 1988; 1991, wat ’n verlenging is van die teorie van beredeneerde optrede (Fishbein & Ajzen, 1975; Ajzen & Fishbein, 1980. Die oogmerk met die implimentering van ’n MIV/VIGS beleid en program is bepaal deur die teorie van planmagtige gedrag soos waargeneem in houding, subjektiewe norme en waargenome gedragskontrole. Die resultate toon dat die teorie van planmagtige gedrag

  14. An assessment of the Zimbabwe ministry of health and child welfare provider initiated HIV testing and counselling programme

    Directory of Open Access Journals (Sweden)

    Sibanda Euphemia L

    2012-05-01

    Full Text Available Abstract Background Provider-initiated HIV testing and counselling (PITC is widely recommended to ensure timely treatment of HIV. The Zimbabwe Ministry of Health introduced PITC in 2007. We aimed to evaluate institutional capacity to implement PITC and investigate patient and health care worker (HCW perceptions of the PITC programme. Methods Purposive selection of health care institutions was conducted among those providing PITC. Study procedures included 1 assessment of implementation procedures and institutional capacity using a semi-structured questionnaire; 2 in-depth interviews with patients who had been offered HIV testing to explore perceptions of PITC, 3 Focus group discussions with HCW to explore views on PITC. Qualitative data was analysed according to Framework Analysis. Results Sixteen health care institutions were selected (two central, two provincial, six district hospitals; and six primary care clinics. All institutions at least offered PITC in part. The main challenges which prevented optimum implementation were shortages of staff trained in PITC, HIV rapid testing and counselling; shortages of appropriate counselling space, and, at the time of assessment, shortages of HIV test kits. Both health care workers and patients embraced PITC because they had noticed that it had saved lives through early detection and treatment of HIV. Although health care workers reported an increase in workload as a result of PITC, they felt this was offset by the reduced number of HIV-related admissions and satisfaction of working with healthier clients. Conclusion PITC has been embraced by patients and health care workers as a life-saving intervention. There is need to address shortages in material, human and structural resources to ensure optimum implementation.

  15. Determinants of HIV sero-conversion among male injection drug users enrolled in a needle exchange programme at Karachi, Pakistan

    International Nuclear Information System (INIS)

    Samo, R. N.; Altaf, A.

    2013-01-01

    Objective: To assess the determinants of HIV sero-conversion among male injection drug users enrolled in needle exchange programme at Karachi. Methods: An unmatched retrospective case control study was conducted among male injection drug users receiving needle exchange services in Karachi. The cases and controls were identified from one drop in center providing needle exchange services. The data for the study participants was collected retrospectively from the programme. Descriptive statistics, univariate analysis, and multivariate regression analysis for determinants of HIV sero-conversion and Hosmer and Lameshow goodness of fit test for model adequacy were performed. Results: Mean age of the study participants was 34.17 +- 10.74 years. Average monthly income of the participants was US$ 125.15+-76.32. In unconditional multivariate regression analysis being unmarried (AOR: 3.0 95% CI 1.14-7.9, p=0.02), not living with family (AOR: 2.8 95% CI 1.18-6.79 p=0.02), family history of addiction (AOR: 2.5, 95% CI 1.01-6.49, p=0.04), injecting drugs in groups (AOR: 2.8, 95% CI 1.12 7.02 p=0.02), not obtaining syringes from the programme (AOR: 26.45, 95% CI 2.47-282.8 p=0.007), and history of blood transfusion (AOR: 52.9, 95% CI 1.32-2118.41 p=0.03) were significantly associated with HIV positive sero-status. Model adequacy was assessed by Hosmer and Lameshow goodness of (J: 4.95, p=0.7) indicating that the model was accurate. Conclusion: Social and drug related risky behaviours are important determinants of HIV among male IDUs in Karachi. The situation calls for programmatic initiatives for addressing the risky behaviours among IDUs for effective control of epidemic in the country. (author)

  16. The value of confirmatory testing in early infant HIV diagnosis programmes in South Africa: A cost-effectiveness analysis.

    Science.gov (United States)

    Dunning, Lorna; Francke, Jordan A; Mallampati, Divya; MacLean, Rachel L; Penazzato, Martina; Hou, Taige; Myer, Landon; Abrams, Elaine J; Walensky, Rochelle P; Leroy, Valériane; Freedberg, Kenneth A; Ciaranello, Andrea

    2017-11-01

    .g., medication toxicities); including these outcomes would further increase the value of confirmatory testing. Without confirmatory testing, in settings with MTCT rates similar to that of South Africa, more than 10% of infants who initiate ART may reflect false-positive diagnoses. Confirmatory testing prevents inappropriate HIV diagnosis, is cost-saving, and should be adopted in all EID programmes.

  17. The value of confirmatory testing in early infant HIV diagnosis programmes in South Africa: A cost-effectiveness analysis.

    Directory of Open Access Journals (Sweden)

    Lorna Dunning

    2017-11-01

    Full Text Available The specificity of nucleic acid amplification tests (NAATs used for early infant diagnosis (EID of HIV infection is <100%, leading some HIV-uninfected infants to be incorrectly identified as HIV-infected. The World Health Organization recommends that infants undergo a second NAAT to confirm any positive test result, but implementation is limited. Our objective was to determine the impact and cost-effectiveness of confirmatory HIV testing for EID programmes in South Africa.Using the Cost-effectiveness of Preventing AIDS Complications (CEPAC-Pediatric model, we simulated EID testing at age 6 weeks for HIV-exposed infants without and with confirmatory testing. We assumed a NAAT cost of US$25, NAAT specificity of 99.6%, NAAT sensitivity of 100% for infants infected in pregnancy or at least 4 weeks prior to testing, and a mother-to-child transmission (MTCT rate at 12 months of 4.9%; we simulated guideline-concordant rates of testing uptake, result return, and antiretroviral therapy (ART initiation (100%. After diagnosis, infants were linked to and retained in care for 10 years (false-positive or lifelong (true-positive. All parameters were varied widely in sensitivity analyses. Outcomes included number of infants with false-positive diagnoses linked to ART per 1,000 ART initiations, life expectancy (LE, in years and per-person lifetime HIV-related healthcare costs. Both without and with confirmatory testing, LE was 26.2 years for HIV-infected infants and 61.4 years for all HIV-exposed infants; clinical outcomes for truly infected infants did not differ by strategy. Without confirmatory testing, 128/1,000 ART initiations were false-positive diagnoses; with confirmatory testing, 1/1,000 ART initiations were false-positive diagnoses. Because confirmatory testing averted costly HIV care and ART in truly HIV-uninfected infants, it was cost-saving: total cost US$1,790/infant tested, compared to US$1,830/infant tested without confirmatory testing

  18. Factors associated with HIV infection among children born to mothers on the prevention of mother to child transmission programme at Chitungwiza Hospital, Zimbabwe, 2008.

    Science.gov (United States)

    Ngwende, Stella; Gombe, Notion T; Midzi, Stanley; Tshimanga, Mufuta; Shambira, Gerald; Chadambuka, Addmore

    2013-12-14

    Zimbabwe is one of the five countries worst affected by the HIV/AIDS pandemic with HIV infection contributing increasingly to childhood morbidity and mortality. Among the children born to HIV positive mothers participating in the PMTCT programme, 25% tested positive to HIV. We investigated factors associated with HIV infection among children born to mothers on the PMTCT programme. A 1:1 unmatched case-control study was conducted at Chitungwiza Hospital, Zimbabwe, 2008. A case was defined as a child who tested HIV positive, born to a mother who had been on PMTCT programme. A control was a HIV negative child born to a mother who had been on PMTCT programme. An interviewer-administered questionnaire was used to collect data on demographic characteristics, risk factors associated with HIV infection and immunization status. A total of 120 mothers were interviewed. Independent risk factors associated with HIV infection among children included maternal CD4 count of less than 200 during pregnancy [aOR = 7.1, 95% CI (2.6-17)], mixed feeding [aOR = 29, 95% CI (4.2-208)], being hospitalized since birth [aOR = 2.9, 95% CI (1.2-4.8)] whilst being exclusively breast fed for less than 6 months [aOR = 0.1 (95% CI 0.03-0.4)] was protective. HIV infection among children increased if the mother's CD4 count was ≤200 cells/μL and if the child was exposed to mixed feeding. Breastfeeding exclusively for less than six months was protective. We recommended exclusive breast feeding period for the first six months and stop breast feeding after 6 months if affordable, sustainable and safe.

  19. An implementation evaluation of a voluntary counselling and testing programme for the human immunodeficiency virus (HIV and acquired immunodeficiency syndrome (AIDS

    Directory of Open Access Journals (Sweden)

    Tarryn N. Anderson

    2012-07-01

    Research purpose: The purpose of this evaluation was to assess whether or not a Voluntary Counselling and Testing (VCT programme for HIV and AIDS, at a South African university, was implemented as intended. Motivation for the study: The evaluators were motivated to explore indications in the existing literature about these programmes that participants in VCT programmes are often not the intended target population who live a high risk lifestyle. Research design, approach and method: A descriptive design was used to evaluate service utlisation, service delivery and organisational support. Questionnaire data from 285 respondents who participated in the programme and programme records supplied by the programme staff were consulted to answer the evaluation questions. Main findings: The evaluation showed that the highest uptake for the programme occurred amongst female students. The low uptake amongst men was a concern. It was found that the programme was delivered as intended and that there were enough resources to implement it according to standards set. Practical/managerial implications: The systematic report on the programme process provided the programme managers with practical suggestions for programme improvement. Contribution/value-add: This was the first implementation evaluation of a VCT programme in a South African university context. As such it aimed to educate programme managers to think evaluatively about introducing new or continuing existing programmes.

  20. Underutilisation of routinely collected data in the HIV programme in Zambia: a review of quantitatively analysed peer-reviewed articles.

    Science.gov (United States)

    Munthali, Tendai; Musonda, Patrick; Mee, Paul; Gumede, Sehlulekile; Schaap, Ab; Mwinga, Alwyn; Phiri, Caroline; Kapata, Nathan; Michelo, Charles; Todd, Jim

    2017-06-13

    The extent to which routinely collected HIV data from Zambia has been used in peer-reviewed published articles remains unexplored. This paper is an analysis of peer-reviewed articles that utilised routinely collected HIV data from Zambia within six programme areas from 2004 to 2014. Articles on HIV, published in English, listed in the Directory of open access journals, African Journals Online, Google scholar, and PubMed were reviewed. Only articles from peer-reviewed journals, that utilised routinely collected data and included quantitative data analysis methods were included. Multi-country studies involving Zambia and another country, where the specific results for Zambia were not reported, as well as clinical trials and intervention studies that did not take place under routine care conditions were excluded, although community trials which referred patients to the routine clinics were included. Independent extraction was conducted using a predesigned data collection form. Pooled analysis was not possible due to diversity in topics reviewed. A total of 69 articles were extracted for review. Of these, 7 were excluded. From the 62 articles reviewed, 39 focused on HIV treatment and retention in care, 15 addressed prevention of mother-to-child transmission, 4 assessed social behavioural change, and 4 reported on voluntary counselling and testing. In our search, no articles were found on condom programming or voluntary male medical circumcision. The most common outcome measures reported were CD4+ count, clinical failure or mortality. The population analysed was children in 13 articles, women in 16 articles, and both adult men and women in 33 articles. During the 10 year period of review, only 62 articles were published analysing routinely collected HIV data in Zambia. Serious consideration needs to be made to maximise the utility of routinely collected data, and to benefit from the funds and efforts to collect these data. This could be achieved with government support

  1. HIV seroconversion among Baltimore City residents tested at a mobile van programme.

    Science.gov (United States)

    Puryear, Sarah; Burnett, Phyllis; Page, Kathleen R; Muvva, Ravikiran; Chaulk, Patrick; Ghanem, Khalil G; Monroe, Anne

    2018-02-01

    Many individuals with HIV in the USA are unaware of their diagnosis, and therefore cannot be engaged in treatment services, have worse clinical outcomes and are more likely to transmit HIV to others. Mobile van testing may increase HIV testing and diagnosis. Our objective was to characterise risk factors for HIV seroconversion among individuals using mobile van testing. A case cohort study (n=543) was conducted within an HIV surveillance dataset of mobile van testing users with at least two HIV tests between September 2004 and August 2009 in Baltimore, Maryland. A subcohort (n=423) was randomly selected; all additional cases were added from the parent cohort. Cases (n=122 total, two from random subcohort) had documented seroconversion at the follow-up visit. A unique aspect of the analysis was use of Department of Corrections data to document incarceration between the times of initial and subsequent testing. Multivariate Cox proportional hazards models were used to compare HIV transmission risk factors between individuals who seroconverted and those who did not. One hundred and twenty-two HIV seroconversions occurred among 8756 individuals (1.4%), a rate higher than that in Baltimore City Health Department's STD Clinic clients (1%). Increased HIV seroconversion risk was associated with men who have sex with men (MSM) (HR 32.76, 95% CI 5.62 to 191.12), sex with an HIV positive partner (HR 70.2, 95% CI 9.58 to 514.89), and intravenous drug use (IDU) (HR 5.65, 95% CI 2.41 to 13.23). HIV testing is a crucial first step in the HIV care continuum and an important HIV prevention tool. This study confirmed the need to reach high-risk populations (MSM, sex with HIV-positive individuals, individuals with IDU) and to increase comprehensive prevention services so that high-risk individuals stay HIV uninfected. HIV testing in mobile vans may be an effective outreach strategy for identifying infection in certain populations at high risk for HIV. © Article author(s) (or

  2. Long-Term Outcome of an HIV-Treatment Programme in Rural Africa: Viral Suppression despite Early Mortality

    Directory of Open Access Journals (Sweden)

    Roos E. Barth

    2011-01-01

    Results. 63% of patients (466/735 have a fully suppressed HIV-RNA, a median of three years after treatment initiation. Early mortality was high: 14% died within 3 months after treatment start. 16% of patients experienced virological failure, but only 4% was switched to second-line ART. Male gender and a low performance score were associated with treatment failure; immunological failure was a poor predictor of virological failure. Conclusions. An “all or nothing” phenomenon was observed in this rural South African ART programme: high early attrition, but good virological control in those remaining in care. Continued efforts are needed to enrol patients earlier. Furthermore, the observed viro-immunological dissociation emphasises the need to make HIV-RNA testing more widely available.

  3. HIV in insurgency forces in sub-Saharan Africa - a personal view of policies.

    Science.gov (United States)

    Miles, Steven H

    2003-03-01

    The special requirements for HIV-prevention programmes by armed forces or insurgency groups in very poor countries that are in active conflict have not been well described. Customary military programme components include: education on sexually transmitted diseases, condom distribution, and HIV testing. Programmes for these armed forces must address: a command structure that may not prioritize this activity, severe resource and logistical constraints, weak health systems for treating sexually transmitted illness, beliefs in traditional medicines for symptoms of sexually transmitted illness, illiteracy that diminishes the utility of educational pamphlets, rape and sexual bartering by soldiers, battlefield transfusions, tattooing and the co-epidemic of tuberculosis.

  4. Improving a mother to child HIV transmission programme through health system redesign: quality improvement, protocol adjustment and resource addition.

    Directory of Open Access Journals (Sweden)

    Michele S Youngleson

    2010-11-01

    Full Text Available Health systems that deliver prevention of mother to child transmission (PMTCT services in low and middle income countries continue to underperform, resulting in thousands of unnecessary HIV infections of newborns each year. We used a combination of approaches to health systems strengthening to reduce transmission of HIV from mother to infant in a multi-facility public health system in South Africa.All primary care sites and specialized birthing centers in a resource constrained sub-district of Cape Metro District, South Africa, were enrolled in a quality improvement (QI programme. All pregnant women receiving antenatal, intrapartum and postnatal infant care in the sub-district between January 2006 and March 2009 were included in the intervention that had a prototype-innovation phase and a rapid spread phase. System changes were introduced to help frontline healthcare workers to identify and improve performance gaps at each step of the PMTCT pathway. Improvement was facilitated and spread through the use of a Breakthrough Series Collaborative that accelerated learning and the spread of successful changes. Protocol changes and additional resources were introduced by provincial and municipal government. The proportion of HIV-exposed infants testing positive declined from 7.6% to 5%. Key intermediate PMTCT processes improved (antenatal AZT increased from 74% to 86%, PMTCT clients on HAART at the time of labour increased from 10% to 25%, intrapartum AZT increased from 43% to 84%, and postnatal HIV testing from 79% to 95% compared to baseline.System improvement methods, protocol changes and addition/reallocation of resources contributed to improved PMTCT processes and outcomes in a resource constrained setting. The intervention requires a clear design, leadership buy-in, building local capacity to use systems improvement methods, and a reliable data system. A systems improvement approach offers a much needed approach to rapidly improve under

  5. Evolution of HIV and AIDS Programmes in an African Institution of Higher Learning: The Case of the Copperbelt University in Zambia

    Science.gov (United States)

    Sanjobo, Nawa; Lukwesa, Matilda; Kaziya, Charity; Tepa, Cornwell; Puta, Bernard

    2016-01-01

    Background: Universities present the foundation for socio-economic and political development. Without structures and processes to fight HIV, there is no prospect of enhancing treatment, prevention, care and support services. Copperbelt University HIV and AIDS response was initiated in 2003 with the aim of building capacity of students and employees in HIV and AIDS. Objectives: The main objective of this paper is to demonstrate how the CBU HIV response has evolved over time and provide a timeline of important milestones in the development process. Method: Peer educators and counsellors conduct sensitization campaigns through one on one discussion, workshops, and drama performances, distribution of Information, Education and Communication (IEC) materials. Results: HIV Programme has been set up with players from policy, programme and community levels. Strategic processes, collaborations, funding, medical insurance schemes, prevention, treatment, care and support services, training of peer educators and counsellors have been established. Conclusion: Copperbelt University HIV initiative has demonstrated potential to reduce new infections in the university, and is currently expanding her programme to encompass wellness and also spearhead the integration of HIV in the university curriculum. PMID:27347269

  6. Evolution of HIV and AIDS Programmes in an African Institution of Higher Learning: The Case of the Copperbelt University in Zambia.

    Science.gov (United States)

    Sanjobo, Nawa; Lukwesa, Matilda; Kaziya, Charity; Tepa, Cornwell; Puta, Bernard

    2016-01-01

    Universities present the foundation for socio-economic and political development. Without structures and processes to fight HIV, there is no prospect of enhancing treatment, prevention, care and support services. Copperbelt University HIV and AIDS response was initiated in 2003 with the aim of building capacity of students and employees in HIV and AIDS. The main objective of this paper is to demonstrate how the CBU HIV response has evolved over time and provide a timeline of important milestones in the development process. Peer educators and counsellors conduct sensitization campaigns through one on one discussion, workshops, and drama performances, distribution of Information, Education and Communication (IEC) materials. HIV Programme has been set up with players from policy, programme and community levels. Strategic processes, collaborations, funding, medical insurance schemes, prevention, treatment, care and support services, training of peer educators and counsellors have been established. Copperbelt University HIV initiative has demonstrated potential to reduce new infections in the university, and is currently expanding her programme to encompass wellness and also spearhead the integration of HIV in the university curriculum.

  7. Retention and mortality on antiretroviral therapy in sub-Saharan Africa: collaborative analyses of HIV treatment programmes.

    Science.gov (United States)

    Haas, Andreas D; Zaniewski, Elizabeth; Anderegg, Nanina; Ford, Nathan; Fox, Matthew P; Vinikoor, Michael; Dabis, François; Nash, Denis; Sinayobye, Jean d'Amour; Niyongabo, Thêodore; Tanon, Aristophane; Poda, Armel; Adedimeji, Adebola A; Edmonds, Andrew; Davies, Mary-Ann; Egger, Matthias

    2018-02-01

    By 2020, 90% of all people diagnosed with HIV should receive long-term combination antiretroviral therapy (ART). In sub-Saharan Africa, this target is threatened by loss to follow-up in ART programmes. The proportion of people retained on ART long-term cannot be easily determined, because individuals classified as lost to follow-up, may have self-transferred to another HIV treatment programme, or may have died. We describe retention on ART in sub-Saharan Africa, first based on observed data as recorded in the clinic databases, and second adjusted for undocumented deaths and self-transfers. We analysed data from HIV-infected adults and children initiating ART between 2009 and 2014 at a sub-Saharan African HIV treatment programme participating in the International epidemiology Databases to Evaluate AIDS (IeDEA). We used the Kaplan-Meier method to calculate the cumulative incidence of retention on ART and the Aalen-Johansen method to calculate the cumulative incidences of death, loss to follow-up, and stopping ART. We used inverse probability weighting to adjust clinic data for undocumented mortality and self-transfer, based on estimates from a recent systematic review and meta-analysis. We included 505,634 patients: 12,848 (2.5%) from Central Africa, 109,233 (21.6%) from East Africa, 347,343 (68.7%) from Southern Africa and 36,210 (7.2%) from West Africa. In crude analyses of observed clinic data, 52.1% of patients were retained on ART, 41.8% were lost to follow-up and 6.0% had died 5 years after ART initiation. After accounting for undocumented deaths and self-transfers, we estimated that 66.6% of patients were retained on ART, 18.8% had stopped ART and 14.7% had died at 5 years. Improving long-term retention on ART will be crucial to attaining the 90% on ART target. Naïve analyses of HIV cohort studies, which do not account for undocumented mortality and self-transfer of patients, may severely underestimate both mortality and retention on ART. © 2018 The

  8. Unappreciated epidemiology: the churn effect in a regional HIV care programme.

    Science.gov (United States)

    Gill, M J; Krentz, H B

    2009-08-01

    High levels of geographic mobility in and out of HIV care centres (i.e. the churn effect) can disrupt the continuity of patient care, misalign prevention services, impact local prevalence data perturbing optimal allocation of resources, and contribute to logical challenges in repeated transfer of health records. We report on the clinical, demographic, and administrative impact of high population turnover within HIV populations.

  9. V3-serotyping programme evaluated for HIV-1 variation in the Netherlands and Curacao

    NARCIS (Netherlands)

    Wolf F de; Akker R van den; Valk M; Bakker M; Goudsmit J; Loon AM van; VIR; UVA/HRL

    1995-01-01

    To obtain insight into the variation of the HIV-1 V3 neutralization domain of variants circulating in the Netherlands, 126 Dutch, 70 Curacao and 45 African serum samples from HIV-1 infected individuals were screened for antibody reactivity to a set of 16 to 17 mer synthetic peptides, representing

  10. Prioritizing Healthcare Delivery in a Conflict Zone Comment on "TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo".

    Science.gov (United States)

    Wood, Robin; Richardson, Eugene T

    2013-09-01

    Nowhere are the barriers to a functional health infrastructure more clearly on display than in the Goma region of Democratic Republic of Congo. Kaboru et al. report poorly integrated services for HIV and TB in this war-torn region. Priorities in conflict zones include provision of security, shelter, food, clean water and prevention of sexual violence. In Goma, immediate health priorities include emergency treatment of cholera, malaria, respiratory illnesses, provision of maternal care, millions of measles vaccinations, and management of an ongoing rabies epidemic. It is a daunting task to determine an essential package of medical services in a setting where there are so many competing priorities, where opportunity costs are limited and epidemiologic information is scarce. Non-governmental agencies sometimes add to the challenge via an insidious reduction of state sovereignty and the creation of new levels of income inequality. Kaboru et al. have successfully highlighted many of the complexities of rebuilding and prioritizing healthcare in a conflict zone.

  11. Determinants of nondisclosure of HIV status among women attending the prevention of mother to child transmission programme, Makonde district, Zimbabwe, 2009.

    Science.gov (United States)

    Mucheto, Pride; Chadambuka, Addmore; Shambira, Gerald; Tshimanga, Mufuta; Gombe, Notion; Nyamayaro, Wenceslas

    2011-01-01

    The 2007 United Nations General Assembly Report on HIV/AIDS in Zimbabwe reported nondisclosure of HIV status as a challenge in the PMTCT programme. Preliminary investigations on nondisclosure among 21 women tested for HIV at Chinhoyi Hospital showed that only six had disclosed their HIV status. We investigated the determinants of nondisclosure of HIV status. A cross sectional analytic study was conducted at six health facilities in Makonde district. The Theory of Planned Behaviour was adapted to guide socio-cultural variables assessed. Antenatal and postnatal women tested for HIV in the PMTCT program who consented to participate were interviewed. We enrolled 334 women. Thirty four percent (114) did not disclose their HIV status. Among HIV positive respondents, 43% (25) did not disclose their status. Women who believed disclosure caused physical abuse (OR=1.81, 95% CI: 1.17-2.90), caused divorce (OR=2.01, 95% CI: 1.25-3.22) and was unimportant (OR= 2.26, 95% CI: 1.33-3.87) were two times less likely to disclose their status. Respondents who received group HIV pre-test counselling were 2.4 times more likely not to disclose. Receiving ANC HIV education at least twice and referral for psychosocial support were significantly protective [OR 0.54 (95% CI 0.24-0.63) and 0.16 (95% CI: 0.06-0.41) respectively. Independent determinants of nondisclosure among HIV positive women were perception that disclosure would cause divorce (AOR=7.82, p=0.03), living with an extended family (AOR=10.3, p=0.01) and needing spousal approval of HIV testing (AOR=0.11, pcauses divorce, abuse or is unimportant contributes to nondisclosure. Identifying women with social challenges and strengthening their referral for psychosocial support can improve disclosure of HIV status and reduce mother to child transmission of HIV.

  12. Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system.

    Science.gov (United States)

    Maher, Dermot

    2010-07-05

    The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens), drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens), research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy development and scaling up interventions, and identify ways

  13. Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system

    Directory of Open Access Journals (Sweden)

    Maher Dermot

    2010-07-01

    Full Text Available Abstract Background The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. Discussion HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens, drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens, research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy

  14. A decade of an HIV workplace programme in armed conflict zones; a social responsibility response of the International Committee of the Red Cross.

    Science.gov (United States)

    Du Mortier, Stéphane; Mukangu, Silas; Sagna, Charles; Nyffenegger, Laurent; Aebischer Perone, Sigiriya

    2016-01-01

    The International Committee of the Red Cross (ICRC) works in fragile States and in armed conflict zones. Some of them are affected by the HIV pandemic. Within the framework of its social responsibility programme concerning HIV affecting its staff members, the organization has implemented an HIV workplace programme since 2004. We carried out a retrospective analysis over 10 years. Data collected were initially essentially qualitative and process-oriented, but were complemented over the years by data on annual voluntary counselling and testing (VCT) uptake and on direct annual costs covering awareness, testing and antiretroviral therapy. The number of people covered by the programme grew from none in 2003 to 4,438 in 2015, with an increase in annual VCT uptake over the years increasing from 376 persons (14 %) in 2007 to 2,663 in 2015 (60 %). Over the years, the services were expanded from awareness raising to bringing VCT to the workplace, as well as offering testing and health coverage of other conditions and innovative approaches to facing challenges linked to situations of violence. Within its social responsibility framework, the ICRC has shown the importance and feasibility of a workplace HIV programme in conflict zones. A sustainable workplace programme in these conflict settings requires constant adaptation, with regular follow-up given the relatively high turnover of staff, and ensuring sustainable stocks of condoms and antiretroviral drugs.

  15. Integration of HIV Care into Community Management of Acute Childhood Malnutrition Permits Good Outcomes: Retrospective Analysis of Three Years of a Programme in Lusaka.

    Science.gov (United States)

    Amadi, Beatrice; Imikendu, Mercy; Sakala, Milika; Banda, Rosemary; Kelly, Paul

    2016-01-01

    While HIV has had a major impact on health care in southern Africa, there are few data on its impact on acute malnutrition in children in the community. We report an analysis of outcomes in a large programme of community management of acute malnutrition in the south of Lusaka. Over 3 years, 68,707 assessments for undernutrition were conducted house-to-house, and children with severe acute malnutrition (SAM) or moderate acute malnutrition (MAM) were enrolled into either Outpatient Therapeutic Programme (OTP) or Supplementary Feeding Programme (SFP) respectively. Case records were analysed using tabulation and unconditional logistic regression. 1,859 children (889 boys, 970 girls; median age 16 months) with MAM (n = 664) or SAM (n = 1,195) were identified. Of 1,796 children whose parents consented to testing, 185 (10.3%) were HIV positive. Altogether 1,163 (62.6%) were discharged as recovered from acute malnutrition. Case fatality while in the programme was 4.2% in children with SAM and 0.5% in those with MAM (RR of SAM 10.9; 95%CI 3.4,34.8; Pmalnutrition programme, incorporating HIV care, can achieve low mortality even in a population heavily affected by HIV.

  16. Partners or donors: The perceived roles of Global Fund Principal Recipient NGOs in HIV prevention programmes in Ukraine

    Directory of Open Access Journals (Sweden)

    Svetlana McGill

    2017-01-01

    Full Text Available Ukraine has one of Europe's fastest growing HIV rates and in 2003–2012 was one of the largest recipients of funding from the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF. Doctoral research recently completed by the author investigates the conduct and practice of international and national nongovernmental organisations (NGOs as Principal Recipients (PRs of GF grants in Ukraine from 2003 to 2012. An ethnographic enquiry including 50 participant interviews was conducted in three oblasts in Ukraine, and in its capital, Kyiv. The paper presents some of the findings that emerged from the analysis. Discussing the PR NGOs roles and practices in delivering HIV prevention programmes funded by GF, the author argues that the anticipated benefits of NGO partnerships between PR NGOs and their Sub-Recipients (SRs have not been achieved. Rather, PRs acted as donors and ran highly discretionary policies in channelling GF funding to SRs that installed competition and vertical relations between NGO-grantors and NGO-grantees. The outcome was a servile civil society that is dependent on external funding and is unable to genuinely represent their communities. With an anticipated GF phasing out from Ukraine, there is a critical lack of advocacy potential of the civil society to articulate and defend the needs of PLHIV when transferring HIV services into state funding.

  17. The outcome of prevention of mother to child transmission (PMTCT) of HIV infection programme in Nnewi, southeast Nigeria.

    Science.gov (United States)

    Ikechebelu, J I; Ugboaja, J O; Kalu, S O; Ugochukwu, E F

    2011-01-01

    A lot of challenges face the current efforts at reducing Mother to Child transmission of HIV infection (MTCT) in Sub Saharan Africa due to limited access to Highly active antiretroviral therapy (HAART) and breast feeding practices. A regular review of progress is necessary in order to identify areas of need. This is a one year prospective descriptive study of seven hundred and twenty six mother-infant pairs managed in the PMTCT programme in Nnamdi Azikiwe University Teaching Hospital, Nnewi Southeast Nigeria. The babies HIV status was tested with PCR for HIV DNA while the mothers provided information on infant feeding pattern and the use of antiretroviral (ARV) drugs including prophylaxis for the baby. Information was augmented from the antenatal records. The transmission rate was 2.8% for mothers, who were on HAART, did not breastfeed and whose babies received ARV prophylactic therapy. But for mothers who did not receive HAART, did breastfeed and whose babies did not received ARV prophylactic therapy, the transmission rate was 37.5%. When both the mother and child received ARV drugs, the transmission rate was significantly lower in those who did not breastfeed (2.8%) than in those who breastfed (12.5%)(P < 0.001). When both the mother and child did not receive ARV drugs, the transmission rate significantly lower in those who did not breastfeed (21.1%)than in those who breastfed (37.5%) (P < 0.02). The use of HAART in PMTCT programme in the under resourced areas can achieve similar success rates to that in the industrialized countries. Breastfeeding reduces the efficacy achieved by the use of ARV drugs. Provision of wider access to HAART as well as adequate counselling and support for safer infant feeding practices is recommended.

  18. effect of a mother-to-child hiv prevention programme on infant

    African Journals Online (AJOL)

    the time of the study the lllV seroprevalence rate among antenatal women was ... has important health, psychological and economic benefits to the mothers. ... HIV status, opinions about exclusive breast-feeding and early weaning practices ...

  19. HIV drug resistance following a decade of the free antiretroviral therapy programme in India: A review

    Directory of Open Access Journals (Sweden)

    Santosh Karade

    2018-01-01

    Conclusions: Although the overall burden of resistance against first-line ART agents remained steady over the study decade, periodic monitoring is essential. There is the need to develop an HIV-1 subtype C-specific resistance database in India.

  20. Measures needed to strengthen strategic HIV/AIDS prevention programmes in China.

    Science.gov (United States)

    Chen, P

    2007-01-01

    This paper traces the commonly believed three phases of the HIV/AIDs epidemic in China from the early 1980s to the present time and reviews how the Chinese Government and NGOs are dealing with the crisis. Transmission routes for HIV infection in China are thought to be via IDUs, blood plasma donors, sexual contacts and from mother-to-child transmissions. The author examined interventions for HIV/ AIDS prevention tried in other countries that could provide useful lessons learned and discussed how they could be adapted or replicated in China. While recognising the need for the treatment of HIV positive persons and AIDS patients, this paper is limited to suggesting a number of proven strategic interventions to prevent new HIV infections in China among the "general population", adolescents in schools, sex workers and their clients, injecting drug users, and, prevention of mother to child transmission of HIV/AIDS to stem the epidemic. An extensive literature search of articles in published academic journals, published and unpublished documents of international agencies and development NGOs and media reports was conducted for data source to this paper. Internet search engines such as ProQuest, PubMed, Google and Yahoo search engines were used as well as hard copies of reports and internal documents available at the UNFPA Country Technical Services Team's Office in Bangkok tapped for information.

  1. Lost opportunities in HIV prevention: programmes miss places where exposures are highest

    Science.gov (United States)

    Sandøy, Ingvild F; Siziya, Seter; Fylkesnes, Knut

    2008-01-01

    Background Efforts at HIV prevention that focus on high risk places might be more effective and less stigmatizing than those targeting high risk groups. The objective of the present study was to assess risk behaviour patterns, signs of current preventive interventions and apparent gaps in places where the risk of HIV transmission is high and in communities with high HIV prevalence. Methods The PLACE method was used to collect data. Inhabitants of selected communities in Lusaka and Livingstone were interviewed about where people met new sexual partners. Signs of HIV preventive activities in these places were recorded. At selected venues, people were interviewed about their sexual behaviour. Peer educators and staff of NGOs were also interviewed. Results The places identified were mostly bars, restaurants or sherbeens, and fewer than 20% reported any HIV preventive activity such as meetings, pamphlets or posters. In 43% of places in Livingstone and 26% in Lusaka, condoms were never available. There were few active peer educators. Among the 432 persons in Lusaka and 676 in Livingstone who were invited for interview about sexual behaviour, consistent condom use was relatively high in Lusaka (77%) but low in Livingstone (44% of men and 34% of women). Having no condom available was the most common reason for not using one. Condom use in Livingstone was higher among individuals socializing in places where condoms always were available. Conclusion In the places studied we found a high prevalence of behaviours with a high potential for HIV transmission but few signs of HIV preventive interventions. Covering the gaps in prevention in these high exposure places should be given the highest priority. PMID:18218124

  2. HIV drug resistance following a decade of the free antiretroviral therapy programme in India: A review.

    Science.gov (United States)

    Karade, Santosh; Chaturbhuj, Devidas N; Sen, Sourav; Joshi, Rajneesh K; Kulkarni, Smita S; Shankar, Subramanian; Gangakhedkar, Raman R

    2018-01-01

    The objective of this review was to assess the burden of HIV drug resistance mutations (DRM) in Indian adults exposed to first-line antiretroviral therapy (ART) as per national guidelines. An advanced search of the published literature on HIV drug resistance in India was performed in the PubMed and Scopus databases. Data pertaining to age, sex, CD4 count, viral load, and prevalence of nucleoside reverse transcriptase inhibitor (NRTI)/non-nucleoside reverse transcriptase inhibitor (NNRTI) DRM were extracted from each publication. Year-wise Indian HIV-1 reverse transcriptase (RT) sequences were retrieved from the Los Alamos HIV database and mutation analyses were performed. A time trend analysis of the proportion of sequences showing NRTI resistance mutations among individuals exposed to first-line ART was conducted. Overall, 23 studies (1046 unique RT sequences) were identified indicating a prevalence of drug resistance to NRTI and NNRTI. The proportion of RT sequences with any DRM, any NRTI DRM, and any NNRTI DRM was 78.39%, 68.83%, and 73.13%, respectively. The temporal trend analysis of individual DRM from sequences retrieved during 2004-2014 indicated a rising trend in K65R mutations (p=0.013). Although the overall burden of resistance against first-line ART agents remained steady over the study decade, periodic monitoring is essential. There is the need to develop an HIV-1 subtype C-specific resistance database in India. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Low knowledge and anecdotal use of unauthorized online HIV self-test kits among attendees at a street-based HIV rapid testing programme in Spain.

    Science.gov (United States)

    Belza, M José; Figueroa, Carmen; Rosales-Statkus, M Elena; Ruiz, Mónica; Vallejo, Fernando; de la Fuente, Luis

    2014-08-01

    The objectives of this study were to estimate the percentage of potential users who know that unauthorized HIV self-tests can be purchased online and the percentage of those who have already used them, and to determine socio-demographic and behavioural correlates. A self-administered questionnaire was employed to collect data from attendees at a street-based HIV testing programme. Logistic regression for rare events was performed. Of the 3340 participants, 5.3% (95% confidence interval (CI) 4.5-6.0%) had knowledge of self-tests being sold online and 7.5% (95% CI 6.6-8.5%) thought they existed but had never seen them; only 0.6% (95% CI 0.3-0.9%) had ever used one. Knowing that self-tests are sold online (odds ratio (OR) 3.6, 95% CI 2.4-5.4) and using them (OR 7.3, 95% CI 2.2-23.8) were associated with having undergone more than two previous HIV tests. Use was also associated with being neither Spanish nor Latin American (OR 3.8, 95% CI 1.2-12.0) and with having a university degree (OR 0.2, 95% CI 0.1-0.7). At the time of the study, the impact on the population of issues related to the use of unauthorized tests was very low. However, media coverage following the approval of self-testing in the USA might have changed the situation. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. "Now That I'm Pregnant, I'm No Longer an Example": Peer Educator Experiences of an HIV Prevention Programme in Cape Town, South Africa

    Science.gov (United States)

    Wolf, Kimberly; Africa, Adelene

    2017-01-01

    Despite the popularity of peer education as an HIV prevention strategy across a range of contexts, understanding of the experiences of those intimately placed within these programmes is limited. Instead, the majority of research in this field relies on hegemonic notions of rational human behaviour that operate under the assumption that knowledge…

  5. Use and neglect of best-practice HIV/AIDS programme guides by ...

    African Journals Online (AJOL)

    However, reported usage of the recognised codes and guidelines to inform workplace HIV/AIDS interventions was low. Although large companies in South Africa may recognise certain interventions as examples of best practice, it appears that these are not being readily implemented. This appears to be partly because the ...

  6. Prevention of mother-to-child transmission of HIV programme: South ...

    African Journals Online (AJOL)

    The 6-week polymerase chain reaction (PCR) baby test uptake was 81% (239 out of 296 live babies). Of those tested, 2.9% (95% CI 1.3 - 6.2) tested HIV positive. Conclusion. Despite challenges faced by PMTCT providers in a resource-constrained setting, this state-aided hospital provides a comprehensive and integrated ...

  7. What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?

    Science.gov (United States)

    Guinness, Lorna

    2011-01-01

    This paper aims to understand the transaction costs implications of two different governance modes for large scale contracting of HIV prevention services to non-governmental organisations (NGOs) in 2 states in India as part of the National AIDS Control Programme between 2001 and 2003. Interviews at purposively selected case study NGOs, contracting agencies and key informants as well as document review were used to compile qualitative data and make comparisons between the states on five themes theoretically proposed to shape transaction costs: institutional environment, informational problems, opportunism, scale of activity and asset specificity (the degree to which investments made specifically for the contract have value elsewhere). The State AIDS Control Society (SACS) in state Y used a management agency to manage the NGO contracts whereas the SACS in state X contracted directly with the NGOs. A high level of uncertainty, endemic corruption and weak information systems served to weaken the contractual relationships in both states. The management agency in state Y enabled the development of a strong NGO network, greater transparency and control over corrupt practises than the contract model in state X. State X’s contractual process was further weakened by inadequate human resources. The application of the transaction cost framework to contracting out public services to NGOs identified the key costs associated with the governance of HIV prevention services through NGO contracts in India. A more successful form of relational contract evolved within the network of the contract management agency and the NGOs. This led to improved flows of information and perceived quality, and limited corrupt practises. It is unlikely that the SACS on its own, with broader responsibilities and limited autonomy can achieve the same ends. The management agency approach therefore appears to be both transaction cost reducing and better able to cope with the large scale of these

  8. What can transaction costs tell us about governance in the delivery of large scale HIV prevention programmes in southern India?

    Science.gov (United States)

    Guinness, Lorna

    2011-06-01

    This paper aims to understand the transaction costs implications of two different governance modes for large scale contracting of HIV prevention services to non-governmental organisations (NGOs) in 2 states in India as part of the National AIDS Control Programme between 2001 and 2003. Interviews at purposively selected case study NGOs, contracting agencies and key informants as well as document review were used to compile qualitative data and make comparisons between the states on five themes theoretically proposed to shape transaction costs: institutional environment, informational problems, opportunism, scale of activity and asset specificity (the degree to which investments made specifically for the contract have value elsewhere). The State AIDS Control Society (SACS) in state Y used a management agency to manage the NGO contracts whereas the SACS in state X contracted directly with the NGOs. A high level of uncertainty, endemic corruption and weak information systems served to weaken the contractual relationships in both states. The management agency in state Y enabled the development of a strong NGO network, greater transparency and control over corrupt practises than the contract model in state X. State X's contractual process was further weakened by inadequate human resources. The application of the transaction cost framework to contracting out public services to NGOs identified the key costs associated with the governance of HIV prevention services through NGO contracts in India. A more successful form of relational contract evolved within the network of the contract management agency and the NGOs. This led to improved flows of information and perceived quality, and limited corrupt practises. It is unlikely that the SACS on its own, with broader responsibilities and limited autonomy can achieve the same ends. The management agency approach therefore appears to be both transaction cost reducing and better able to cope with the large scale of these

  9. Cost-effectiveness of HIV prevention for high-risk groups at scale: an economic evaluation of the Avahan programme in south India.

    Science.gov (United States)

    Vassall, Anna; Pickles, Michael; Chandrashekar, Sudhashree; Boily, Marie-Claude; Shetty, Govindraj; Guinness, Lorna; Lowndes, Catherine M; Bradley, Janet; Moses, Stephen; Alary, Michel; Vickerman, Peter

    2014-09-01

    Avahan is a large-scale, HIV preventive intervention, targeting high-risk populations in south India. We assessed the cost-effectiveness of Avahan to inform global and national funding institutions who are considering investing in worldwide HIV prevention in concentrated epidemics. We estimated cost effectiveness from a programme perspective in 22 districts in four high-prevalence states. We used the UNAIDS Costing Guidelines for HIV Prevention Strategies as the basis for our costing method, and calculated effect estimates using a dynamic transmission model of HIV and sexually transmitted disease transmission that was parameterised and fitted to locally observed behavioural and prevalence trends. We calculated incremental cost-effective ratios (ICERs), comparing the incremental cost of Avahan per disability-adjusted life-year (DALY) averted versus a no-Avahan counterfactual scenario. We also estimated incremental cost per HIV infection averted and incremental cost per person reached. Avahan reached roughly 150 000 high-risk individuals between 2004 and 2008 in the 22 districts studied, at a mean cost per person reached of US$327 during the 4 years. This reach resulted in an estimated 61 000 HIV infections averted, with roughly 11 000 HIV infections averted in the general population, at a mean incremental cost per HIV infection averted of $785 (SD 166). We estimate that roughly 1 million DALYs were averted across the 22 districts, at a mean incremental cost per DALY averted of $46 (SD 10). Future antiretroviral treatment (ART) cost savings during the lifetime of the cohort exposed to HIV prevention were estimated to be more than $77 million (compared with the slightly more than $50 million spent on Avahan in the 22 districts during the 4 years of the study). This study provides evidence that the investment in targeted HIV prevention programmes in south India has been cost effective, and is likely to be cost saving if a commitment is made to provide ART to all

  10. IT Project Prioritization Process

    DEFF Research Database (Denmark)

    Shollo, Arisa; Constantiou, Ioanna

    2013-01-01

    In most of the large companies IT project prioritization process is designed based on principles of evidencebased management. We investigate a case of IT project prioritization in a financial institution, and in particular, how managers practice evidence-based management during this process. We use...... a rich dataset built from a longitudinal study of the prioritization process for the IT projects. Our findings indicate that managers reach a decision not only by using evidence but from the interplay between the evidence and the judgment devices that managers employ. The interplay between evidence...

  11. HIV / AIDS in the workplace: principles, planning, policy, programmes and project participation.

    Science.gov (United States)

    Smart, R

    1999-01-01

    15 years ago, most business, labor, government, and nongovernment representatives would have had only a small idea of what AIDS was, and let alone why it should concern them. However, companies have since lost top managers, workers have lost colleagues, and considerable time, energy, and emotion have been spent upon issues of illness and loss. Entire families have collapsed, as companies struggle against a background of chronic poverty. The HIV/AIDS pandemic has forced a reconsideration of whether disease prevention and health promotion are business concerns. AIDS causes illness, disability, and death to workers, as well as severe economic and emotional disruptions to their families. It also increases the cost of doing business. As South Africa faces a large epidemic, business must take prompt and incisive action against AIDS. A list of 10 workplace principles is presented and a 3-stage process recommended to ensure optimal workplace HIV/AIDS/STD and tuberculosis policies and programs.

  12. Lived experiences of HIV community workers participating in a community empowerment programme

    Directory of Open Access Journals (Sweden)

    Juliana Horn

    2014-08-01

    Objectives: The researcher explored the lived experiences of HIV community workers participating in two CEPs in Ladysmith, KwaZulu-Natal in order to develop recommendations for CEPs. Method: Data were explored using a qualitative hermeneutic phenomenological approach. Ten participants who had been involved in HIV CEPs for more than six months were identified and individual interviews were held. Results: Three themes emerged, namely, giving of yourself, maintaining sustainability and assisting the CEPs and community workers. Each of these themes also contained a number of subthemes. Exploring the lived experience of the community workers revealed that there are a number of ways in which to promote the sustainability of CEPs. Conclusion: The community should be involved in all aspects of the CEP and community workers must respect the community and their knowledge, experience and value systems.

  13. Prioritization of Capital Projects

    National Research Council Canada - National Science Library

    LaVielle, Michael

    2002-01-01

    Public works capital projects in the U,S, naval forces are not prioritized and funded in a way that best uses limited operations resources and maintenance dollars, This thesis develops a linear model...

  14. Prioritizing Healthcare Delivery in a Conflict Zone; Comment on “TB/HIV Co-Infection Care in Conflict-Affected Settings: A Mapping of Health Facilities in the Goma Area, Democratic Republic of Congo”

    Directory of Open Access Journals (Sweden)

    Robin Wood

    2013-01-01

    Full Text Available Nowhere are the barriers to a functional health infrastructure more clearly on display than in the Goma region of Democratic Republic of Congo. Kaboru et al. report poorly integrated services for HIV and TB in this war-torn region. Priorities in conflict zones include provision of security, shelter, food, clean water and prevention of sexual violence. In Goma, immediate health priorities include emergency treatment of cholera, malaria, respiratory illnesses, provision of maternal care, millions of measles vaccinations, and management of an ongoing rabies epidemic. It is a daunting task to determine an essential package of medical services in a setting where there are so many competing priorities, where opportunity costs are limited and epidemiologic information is scarce. Non-governmental agencies sometimes add to the challenge via an insidious reduction of state sovereignty and the creation of new levels of income inequality. Kaboru et al. have successfully highlighted many of the complexities of rebuilding and prioritizing healthcare in a conflict zone.

  15. Setting Research Priorities for HIV/AIDS-related research in a post-graduate training programme: lessons learnt from the Nigeria Field Epidemiology and Laboratory Training Programme scientific workshop

    Science.gov (United States)

    Poggensee, Gabriele; Waziri, Ndadilnasiya Endie; Bashorun, Adebobola; Nguku, Patrick Mboya; Fawole, Olufunmilayo Ibitola; Sabitu, Kabir

    2014-01-01

    In Nigeria the current prevalence of HIV is 4.1% with over 3.5 million infected and estimated 1.5 million in need of anti-retroviral treatment. Epidemiological and implementation studies are necessary for monitoring and evaluation of interventions. To define research areas which can be addressed by participants of the Nigeria Field Epidemiology and Training Programme (NFELTP) a workshop was held in April 2013 in Abuja, Nigeria. Priority research areas were identified using criteria lists for ranking of the relevance of research questions. Based on a research matrix, NFELTP residents developed the aims and objectives, study design for HIV-related research proposals. This workshop was the first workshop held by the NFELTP to establish an inventory of research questions which can be addressed by the residents within their training period. This inventory will help to increase HIV/AIDS-related activities of NFELTP which are in accordance with research needs in Nigeria and PEPFAR objectives. PMID:25426209

  16. CASE REPORT - Findings from an HIV/AIDS programme for young ...

    African Journals Online (AJOL)

    Il n\\'existe que très peu de renseignements sur les interventions qui s\\'occupent des besoins des jeunes femmes nigérianes; une population qui représente une haute incidence et prévalence du VIH/SIDA. Nous avons sollicité des réponses de la part des participants au programme à l\\'aide des questionnaires de pré et ...

  17. HIV diversity and drug resistance from plasma and non-plasma analytes in a large treatment programme in western Kenya.

    Science.gov (United States)

    Kantor, Rami; DeLong, Allison; Balamane, Maya; Schreier, Leeann; Lloyd, Robert M; Injera, Wilfred; Kamle, Lydia; Mambo, Fidelis; Muyonga, Sarah; Katzenstein, David; Hogan, Joseph; Buziba, Nathan; Diero, Lameck

    2014-01-01

    Antiretroviral resistance leads to treatment failure and resistance transmission. Resistance data in western Kenya are limited. Collection of non-plasma analytes may provide additional resistance information. We assessed HIV diversity using the REGA tool, transmitted resistance by the WHO mutation list and acquired resistance upon first-line failure by the IAS-USA mutation list, at the Academic Model Providing Access to Healthcare (AMPATH), a major treatment programme in western Kenya. Plasma and four non-plasma analytes, dried blood-spots (DBS), dried plasma-spots (DPS), ViveST(TM)-plasma (STP) and ViveST-blood (STB), were compared to identify diversity and evaluate sequence concordance. Among 122 patients, 62 were treatment-naïve and 60 treatment-experienced; 61% were female, median age 35 years, median CD4 182 cells/µL, median viral-load 4.6 log10 copies/mL. One hundred and ninety-six sequences were available for 107/122 (88%) patients, 58/62 (94%) treatment-naïve and 49/60 (82%) treated; 100/122 (82%) plasma, 37/78 (47%) attempted DBS, 16/45 (36%) attempted DPS, 14/44 (32%) attempted STP from fresh plasma and 23/34 (68%) from frozen plasma, and 5/42 (12%) attempted STB. Plasma and DBS genotyping success increased at higher VL and shorter shipment-to-genotyping time. Main subtypes were A (62%), D (15%) and C (6%). Transmitted resistance was found in 1.8% of plasma sequences, and 7% combining analytes. Plasma resistance mutations were identified in 91% of treated patients, 76% NRTI, 91% NNRTI; 76% dual-class; 60% with intermediate-high predicted resistance to future treatment options; with novel mutation co-occurrence patterns. Nearly 88% of plasma mutations were identified in DBS, 89% in DPS and 94% in STP. Of 23 discordant mutations, 92% in plasma and 60% in non-plasma analytes were mixtures. Mean whole-sequence discordance from frozen plasma reference was 1.1% for plasma-DBS, 1.2% plasma-DPS, 2.0% plasma-STP and 2.3% plasma-STB. Of 23 plasma

  18. Characteristics and comprehensiveness of adult HIV care and treatment programmes in Asia-Pacific, sub-Saharan Africa and the Americas

    DEFF Research Database (Denmark)

    Duda, Stephany N; Farr, Amanda M; Lindegren, Mary Lou

    2014-01-01

    in the International epidemiologic Databases to Evaluate AIDS completed a site survey from 2009 to 2010, including sites in the Asia-Pacific region (n=20), Latin America and the Caribbean (n=7), North America (n=7), Central Africa (n=12), East Africa (n=51), Southern Africa (n=16) and West Africa (n=15). We computed...... a measure of the comprehensiveness of care based on seven World Health Organization-recommended essential HIV services. RESULTS: Most sites reported serving urban (61%; region range (rr): 33-100%) and both adult and paediatric populations (77%; rr: 29-96%). Only 45% of HIV clinics that reported treating...... services. Newer sites and sites in settings with low rankings on the UN Human Development Index (HDI), especially those in the President's Emergency Plan for AIDS Relief focus countries, tended to offer a more comprehensive array of essential services. HIV care programme characteristics...

  19. Assessment of the population-level effectiveness of the Avahan HIV-prevention programme in South India: a preplanned, causal-pathway-based modelling analysis.

    Science.gov (United States)

    Pickles, Michael; Boily, Marie-Claude; Vickerman, Peter; Lowndes, Catherine M; Moses, Stephen; Blanchard, James F; Deering, Kathleen N; Bradley, Janet; Ramesh, Banadakoppa M; Washington, Reynold; Adhikary, Rajatashuvra; Mainkar, Mandar; Paranjape, Ramesh S; Alary, Michel

    2013-11-01

    Avahan, the India AIDS initiative of the Bill & Melinda Gates Foundation, was a large-scale, targeted HIV prevention intervention. We aimed to assess its overall effectiveness by estimating the number and proportion of HIV infections averted across Avahan districts, following the causal pathway of the intervention. We created a mathematical model of HIV transmission in high-risk groups and the general population using data from serial cross-sectional surveys (integrated behavioural and biological assessments, IBBAs) within a Bayesian framework, which we used to reproduce HIV prevalence trends in female sex workers and their clients, men who have sex with men, and the general population in 24 South Indian districts over the first 4 years (2004-07 or 2005-08 dependent on the district) and the full 10 years (2004-13) of the Avahan programme. We tested whether these prevalence trends were more consistent with self-reported increases in consistent condom use after the implementation of Avahan or with a counterfactual (assuming consistent condom use increased at slower, pre-Avahan rates) using a Bayes factor, which gave a measure of the strength of evidence for the effectiveness estimates. Using regression analysis, we extrapolated the prevention effect in the districts covered by IBBAs to all 69 Avahan districts. In 13 of 24 IBBA districts, modelling suggested medium to strong evidence for the large self-reported increase in consistent condom use since Avahan implementation. In the remaining 11 IBBA districts, the evidence was weaker, with consistent condom use generally already high before Avahan began. Roughly 32700 HIV infections (95% credibility interval 17900-61600) were averted over the first 4 years of the programme in the IBBA districts with moderate to strong evidence. Addition of the districts with weaker evidence increased this total to 62800 (32000-118000) averted infections, and extrapolation suggested that 202000 (98300-407000) infections were averted

  20. Patient satisfaction with HIV and TB treatment in a public programme in rural KwaZulu-Natal: evidence from patient-exit interviews

    Science.gov (United States)

    2014-01-01

    Background Patient satisfaction is a determinant of treatment uptake, adherence and retention, and an important health systems outcome. Queues, health worker-patient contact time, staff attitudes, and facility cleanliness may affect patient satisfaction. We quantified dimensions of patient satisfaction among HIV and TB patients in a rural sub-district of KwaZulu-Natal, South Africa, and identified underlying satisfaction factors that explained the data. Methods We conducted patient-exit interviews with 300 HIV and 300 TB patients who were randomly selected using a two-stage cluster random sampling approach with primary sampling units (primary healthcare clinics) selected with probability-proportional-to-size sampling. We performed factor analysis to investigate underlying patient satisfaction factors. We compared the satisfaction with HIV and TB services and examined the relationships between patient satisfaction and patients’ socio-demographic characteristics in multivariable regression. Results Almost all patients (95% HIV, 97% TB) reported to be globally satisfied with the healthcare services received on the day of the interview. However, patient satisfaction with specific concrete aspects of the health services was substantially lower: 52% of HIV and 40% of TB patients agreed that some staff did not treat patients with sufficient respect (p = 0.02 for difference between the two patient groups); 65% of HIV and 40% of TB patients agreed that health worker queues were too long (p patient satisfaction variables could be reduced to a few underlying factors that align broadly with concepts previously identified in the literature as affecting access to healthcare. Increases in health systems resources for HIV and TB, but also improvements in facility maintenance, staff attitudes and communication, are likely to substantially improve HIV and TB patients’ satisfaction with the care they receive in public-sector treatment programmes in rural communities in South

  1. "That is why I stopped the ART": patients' & providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme.

    Science.gov (United States)

    Dahab, Mison; Charalambous, Salome; Hamilton, Robin; Fielding, Katherine; Kielmann, Karina; Churchyard, Gavin J; Grant, Alison D

    2008-02-18

    As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. We conducted key informant interviews with 12 participants: six ART patients, five health service providers (HSPs) and one human resources manager. The main reported barriers were denial of existence of HIV or of one's own positive status, use of traditional medicines, speaking a different language from the HSP, alcohol use, being away from home, perceived severity of side-effects, feeling better on treatment and long waiting times at the clinic. The key facilitators were social support, belief in the value of treatment, belief in the importance of one's own life to the survival of one's family, and the ability to fit ART into daily life schedules. Given the reported uncertainty about the existence of HIV disease and the use of traditional medicines while on ART, despite a programme emphasising ART counselling, there is a need to find effective ways to support adherence to ART even if the individual does not accept biomedical concepts of HIV disease or decides to use traditional medicines. Additionally, providers should identify ways to minimize barriers in communication with patients with whom they have no common language. Finally, dissatisfaction with clinical services, due to long waiting times, should be addressed.

  2. "That is why I stopped the ART": Patients' & providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme

    Directory of Open Access Journals (Sweden)

    Kielmann Karina

    2008-02-01

    Full Text Available Abstract Background As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. Methods We conducted key informant interviews with 12 participants: six ART patients, five health service providers (HSPs and one human resources manager. Results The main reported barriers were denial of existence of HIV or of one's own positive status, use of traditional medicines, speaking a different language from the HSP, alcohol use, being away from home, perceived severity of side-effects, feeling better on treatment and long waiting times at the clinic. The key facilitators were social support, belief in the value of treatment, belief in the importance of one's own life to the survival of one's family, and the ability to fit ART into daily life schedules. Conclusion Given the reported uncertainty about the existence of HIV disease and the use of traditional medicines while on ART, despite a programme emphasising ART counselling, there is a need to find effective ways to support adherence to ART even if the individual does not accept biomedical concepts of HIV disease or decides to use traditional medicines. Additionally, providers should identify ways to minimize barriers in communication with patients with whom they have no common language. Finally, dissatisfaction with clinical services, due to long waiting times, should be addressed.

  3. A police education programme to integrate occupational safety and HIV prevention: protocol for a modified stepped-wedge study design with parallel prospective cohorts to assess behavioural outcomes

    Science.gov (United States)

    Strathdee, Steffanie A; Arredondo, Jaime; Rocha, Teresita; Abramovitz, Daniela; Rolon, Maria Luisa; Patiño Mandujano, Efrain; Rangel, Maria Gudelia; Olivarria, Horcasitas Omar; Gaines, Tommi; Patterson, Thomas L; Beletsky, Leo

    2015-01-01

    Introduction Policing practices are key drivers of HIV among people who inject drugs (PWID). This paper describes the protocol for the first study to prospectively examine the impact of a police education programme (PEP) to align law enforcement and HIV prevention. PEPs incorporating HIV prevention (including harm reduction programmes like syringe exchange) have been successfully piloted in several countries but were limited to brief pre–post assessments; the impact of PEPs on policing behaviours and occupational safety is unknown. Objectives Proyecto ESCUDO (SHIELD) aims to evaluate the efficacy of the PEP on uptake of occupational safety procedures, as assessed through the incidence of needle stick injuries (NSIs) (primary outcome) and changes in knowledge of transmission, prevention and treatment of HIV and viral hepatitis; attitudes towards PWID, adverse behaviours that interfere with HIV prevention and protective behaviours (secondary outcomes). Methods/analysis ESCUDO is a hybrid type I design that simultaneously tests an intervention and an implementation strategy. Using a modified stepped-wedge design involving all active duty street-level police officers in Tijuana (N=∼1200), we will administer one 3 h PEP course to groups of 20–50 officers until the entire force is trained. NSI incidence and geocoded arrest data will be assessed from department-wide de-identified data. Of the consenting police officers, a subcohort (N=500) will be randomly sampled from each class to undergo pre-PEP and post-PEP surveys with a semiannual follow-up for 2 years to assess self-reported NSIs, attitudes and behaviour changes. The impact on PWIDs will be externally validated through a parallel cohort of Tijuana PWIDs. Ethics/dissemination Research ethics approval was obtained from the USA and Mexico. Findings will be disseminated through open access to protocol materials through the Law Enforcement and HIV Network. Trial registration number NCT02444403. PMID:26260350

  4. Prioritized Abduction with CHR

    DEFF Research Database (Denmark)

    Christiansen, Henning

    2008-01-01

    A class of Prioritized Abductive Logic Programs (PrioALPs) is introduced and an implementation is developed in CHR for solving abductive problems, providing minimal explanations with best-first search. Priorities may represent probabilities or a cost function to be optimized. Compared with other...

  5. Development and implementation of a peer-based mental health support programme for adolescents orphaned by HIV/AIDS in South Africa.

    Science.gov (United States)

    Thupayagale-Tshweneagae, Gloria

    2011-12-01

    The article describes a framework and the process for the development of the peer-based mental health support programme and its implementation. The development of a peer-based mental health support programme is based on Erikson's theory on the adolescent phase of development, the psycho-educational processes; the peer approach and the orphaned adolescents lived experiences as conceptual framework. A triangulation of five qualitative methods of photography, reflective diaries, focus groups, event history calendar and field notes were used to capture the lived experiences of adolescents orphaned to HIV and AIDS. Analysis of data followed Colaizzi's method of data analysis. The combination of psycho-education, Erikson's stages of development and peer support assisted the participants to gain knowledge and skills to overcome adversity and to assist them to become to more resilient. The peer based mental health support programme if used would enhance the mental health of adolescent orphans.

  6. Programmes for the prevention of parent-to-child transmission of HIV in Papua New Guinea: Health system challenges and opportunities.

    Science.gov (United States)

    Tynan, Anna; Vallely, Lisa; Kupul, Martha; Neo, Ruthy; Fiya, Voletta; Worth, Heather; Kariwiga, Grace; Mola, Glen D L; Kaldor, John; Kelly-Hanku, Angela

    2018-01-01

    Prevention of parent-to-child transmission (PPTCT) of HIV is a highly complex package of interventions, which spans services in both maternal and child health programmes. In Papua New Guinea (PNG), a commitment to ensure that all pregnant women and their partners have access to the full range of PPTCT interventions exists; however, efforts to increase access and utilisation of PPTCT remain far from optimal. The aim of this paper is to examine health care worker (HCW) perception of health system factors impacting on the performance of PPTCT programmes. Sixteen interviews were undertaken with HCWs involved in the PPTCT programme. Application of the WHO 6 building blocks of a health system was applied, and further thematic analysis was conducted on the data with assistance from the analysis software NVivo. Broken equipment, problems with access to medication and supplies, and poorly supported workforce were reported as barriers for implementing a successful PPTCT programme. The absence of central coordination of this complex, multistaged programme was also recognised as a key issue. The study findings highlight an important need for investment in appropriately trained and supported HCWs and integration of services at each stage of the PPTCT programme. Lessons from the PPTCT experience in PNG may inform policy discussions and considerations in other similar contexts. Copyright © 2017 John Wiley & Sons, Ltd.

  7. Severe morbidity and mortality in untreated HIV-infected children in a paediatric care programme in Abidjan, Côte d'Ivoire, 2004-2009

    Directory of Open Access Journals (Sweden)

    Alioum Ahmadou

    2011-06-01

    Full Text Available Abstract Background Clinical evolution of HIV-infected children who have not yet initiated antiretroviral treatment (ART is poorly understood in Africa. We describe severe morbidity and mortality of untreated HIV-infected children. Methods All HIV-infected children enrolled from 2004-2009 in a prospective HIV programme in two health facilities in Abidjan, Côte d'Ivoire, were eligible from their time of inclusion. Risks of severe morbidity (the first clinical event leading to death or hospitalisation and mortality were documented retrospectively and estimated using cumulative incidence functions. Associations with baseline characteristics were assessed by competing risk regression models between outcomes and antiretroviral initiation. Results 405 children were included at a median age of 4.5 years; at baseline, 66.9% were receiving cotrimoxazole prophylaxis, and 27.7% met the 2006 WHO criteria for immunodeficiency by age. The risk of developing a severe morbid event was 14% (95%CI: 10.7 - 17.8 at 18 months; this risk was lower in children previously exposed to any prevention of mother-to-child-transmission (PMTCT intervention (adjusted subdistribution hazard ratio [sHR]: 0.16, 95% CI: 0.04 - 0.71 versus those without known exposure. Cumulative mortality reached 5.5% (95%CI: 3.5 - 8.1 at 18 months. Mortality was associated with immunodeficiency (sHR: 6.02, 95% CI: 1.28-28.42. Conclusions Having benefited from early access to care minimizes the severe morbidity risk for children who acquire HIV. Despite the receipt of cotrimoxazole prophylaxis, the risk of severe morbidity and mortality remains high in untreated HIV-infected children. Such evidence adds arguments to promote earlier access to ART in HIV-infected children in Africa and improve care interventions in a context where treatment is still not available to all.

  8. Declines in violence and police arrest among female sex workers in Karnataka state, south India, following a comprehensive HIV prevention programme.

    Science.gov (United States)

    Beattie, Tara S; Bhattacharjee, Parinita; Isac, Shajy; Mohan, H L; Simic-Lawson, Milena; Ramesh, B M; Blanchard, James F; Moses, Stephen; Watts, Charlotte H; Heise, Lori

    2015-01-01

    Female sex workers (FSWs) frequently experience violence, harassment and arrest by the police or their clients, but there is little evidence as to the impact that such factors may have on HIV risk or whether community interventions could mitigate this impact. As part of the evaluation of the Avahan programme in Karnataka, serial integrated behavioural and biological assessment (IBBA) surveys (four districts) (2005 to 2011) and anonymous polling booth surveys (PBS) (16 districts) (2007 to 2011) were conducted with random samples of FSWs. Logistic regression analysis was used to assess 1) changes in reported violence and arrests over time and 2) associations between violence by non-partners and police arrest and HIV/STI risk and prevalence. Mediation analysis was used to identify mediating factors. 5,792 FSWs participated in the IBBAs and 15,813 participated in the PBS. Over time, there were significant reductions in the percentages of FSWs reporting being raped in the past year (PBS) (30.0% in 2007, 10.0% in 2011, pViolence by non-partners (being raped in the past year and/or beaten in the past six months) and being arrested in the past year were both strongly associated with HIV infection [AOR 1.59 (1.18, 2.15), p=0.002; AOR 1.91 (1.17, 3.12), p=0.01, respectively]. They were also associated with drinking alcohol (during the past week) [AOR 1.98 (1.54, 2.53), pviolence or arrests and HIV prevalence. Violence by non-partners and arrest are both strongly associated with HIV infection among FSWs. Large-scale, comprehensive HIV prevention programming can reduce violence, arrests and HIV/STI infection among FSWs.

  9. Two cross-sectional studies in south India assessing the effect of an HIV prevention programme for female sex workers on reducing syphilis among their clients.

    Science.gov (United States)

    Rajaram, Subramanian Potty; Banandur, Pradeep; Thammattoor, Usha K; Thomas, Tinku; Mainkar, Mandar K; Paranjape, Ramesh; Adhikary, Rajatashurva; Duchesne, Thierry; Ramesh, Banadakoppa M; Isac, Shajy; Moses, Stephen; Alary, Michel

    2014-11-01

    To assess the impact of the Avahan HIV prevention programme for female sex workers (FSWs) in south India on reducing syphilis prevalence among their clients, by comparing rates of syphilis over time as reported in two large-scale surveys of FSWs' clients. A random-effect multilevel logistic regression analysis was performed using syphilis as the dependent variable, with individual independent variables (from the two survey rounds) at level 1 and the district-level programme (from the Avahan computerised monitoring and information system) and contextual variables (from Indian government datasets) at level 2. Programme variables included their 2006 value and their difference in value between 2008 and 2006, as well as the interaction between the latter and the study round. The analysis also controlled for baseline syphilis prevalence and its interaction with the study round. Syphilis decreased significantly among FSWs' clients, from 4.8% (round 1) to 2.6% (round 2), p<0.001. The OR of the interaction term between the difference in programme coverage of FSWs and the round was 0.98 (p=0.023), suggesting that increased coverage was associated with a reduced incidence of syphilis. This study suggests that the Avahan intervention programme among FSWs reduced syphilis rates among their clients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Community voices: barriers and opportunities for programmes to successfully prevent vertical transmission of HIV identified through consultations among people living with HIV.

    Science.gov (United States)

    Anderson, Ginna; Caswell, Georgina; Edwards, Olive; Hsieh, Amy; Hull, Beri; Mallouris, Christoforos; Mason, Naisiadet; Nöstlinger, Christiana

    2012-07-11

    In 2010, two global networks of people living with HIV, the International Community of Women Living with HIV (ICW Global) and the Global Network of People living with HIV (GNP+) were invited to review a draft strategic framework for the global scale up of prevention of vertical transmission (PVT) through the primary prevention of HIV and the prevention of unintended pregnancies among women living with HIV. In order to ensure recommendations were based on expressed needs of people living with HIV, GNP+ and ICW Global undertook a consultation amongst people living with HIV which highlighted both facilitators and barriers to prevention services. This commentary summarizes the results of that consultation. The consultation was comprised of an online consultation (moderated chat-forum with 36 participants from 16 countries), an anonymous online e-survey (601 respondents from 58 countries), and focus-group discussions with people living with HIV in Jamaica (27 participants). The consultation highlighted the discrepancies across regions with respect to access to essential packages of PVT services. However, the consultation participants also identified common barriers to access, including a lack of trustworthy sources of information, service providers' attitudes, and gender-based violence. In addition, participant responses revealed common facilitators of access, including quality counselling on reproductive choices, male involvement, and decentralized services. The consultation provided some understanding and insight into the participants' experiences with and recommendations for PVT strategies. Participants agreed that successful, comprehensive PVT programming require greater efforts to both prevent primary HIV infection among young women and girls and, in particular, targeted efforts to ensure that women living with HIV and their partners are supported to avoid unintended pregnancies and to have safe, healthy pregnancies instead. In addition to providing the insights

  11. GeneXpert HIV-1 quant assay, a new tool for scale up of viral load monitoring in the success of ART programme in India.

    Science.gov (United States)

    Kulkarni, Smita; Jadhav, Sushama; Khopkar, Priyanka; Sane, Suvarna; Londhe, Rajkumar; Chimanpure, Vaishali; Dhilpe, Veronica; Ghate, Manisha; Yelagate, Rajendra; Panchal, Narayan; Rahane, Girish; Kadam, Dilip; Gaikwad, Nitin; Rewari, Bharat; Gangakhedkar, Raman

    2017-07-21

    Recent WHO guidelines identify virologic monitoring for diagnosing and confirming ART failure. In view of this, validation and scale up of point of care viral load technologies is essential in resource limited settings. A systematic validation of the GeneXpert® HIV-1 Quant assay (a point-of-care technology) in view of scaling up HIV-1 viral load in India to monitor the success of national ART programme was carried out. Two hundred nineteen plasma specimens falling in nine viral load ranges (5 L copies/ml) were tested by the Abbott m2000rt Real Time and GeneXpert HIV-1 Quant assays. Additionally, 20 seronegative; 16 stored specimens and 10 spiked controls were also tested. Statistical analysis was done using Stata/IC and sensitivity, specificity, PPV, NPV and %misclassification rates were calculated as per DHSs/AISs, WHO, NACO cut-offs for virological failure. The GeneXpert assay compared well with the Abbott assay with a higher sensitivity (97%), specificity (97-100%) and concordance (91.32%). The correlation between two assays (r = 0.886) was statistically significant (p performance and rapidity will aid in timely diagnosis of ART failures, integrated HIV-TB management and will facilitate the UNAIDS 90-90-90 target.

  12. Prioritizing equipment for replacement.

    Science.gov (United States)

    Capuano, Mike

    2010-01-01

    It is suggested that clinical engineers take the lead in formulating evaluation processes to recommend equipment replacement. Their skill, knowledge, and experience, combined with access to equipment databases, make them a logical choice. Based on ideas from Fennigkoh's scheme, elements such as age, vendor support, accumulated maintenance cost, and function/risk were used.6 Other more subjective criteria such as cost benefits and efficacy of newer technology were not used. The element of downtime was also omitted due to the data element not being available. The resulting Periop Master Equipment List and its rationale was presented to the Perioperative Services Program Council. They deemed the criteria to be robust and provided overwhelming acceptance of the list. It was quickly put to use to estimate required capital funding, justify items already thought to need replacement, and identify high-priority ranked items for replacement. Incorporating prioritization criteria into an existing equipment database would be ideal. Some commercially available systems do have the basic elements of this. Maintaining replacement data can be labor-intensive regardless of the method used. There is usually little time to perform the tasks necessary for prioritizing equipment. However, where appropriate, a clinical engineering department might be able to conduct such an exercise as shown in the following case study.

  13. (ARV) treatment training programme

    African Journals Online (AJOL)

    Winnie

    Keywords:ARV, training, evaluation, HIV, health care provider. RÉSUMÉ .... workers, adequate laboratory facilities for measuring viral load and .... questionnaire guide, the head of unit of the ART ...... begins its scale-up programme. Some of ...

  14. Prioritized Contact Transport Stream

    Science.gov (United States)

    Hunt, Walter Lee, Jr. (Inventor)

    2015-01-01

    A detection process, contact recognition process, classification process, and identification process are applied to raw sensor data to produce an identified contact record set containing one or more identified contact records. A prioritization process is applied to the identified contact record set to assign a contact priority to each contact record in the identified contact record set. Data are removed from the contact records in the identified contact record set based on the contact priorities assigned to those contact records. A first contact stream is produced from the resulting contact records. The first contact stream is streamed in a contact transport stream. The contact transport stream may include and stream additional contact streams. The contact transport stream may be varied dynamically over time based on parameters such as available bandwidth, contact priority, presence/absence of contacts, system state, and configuration parameters.

  15. Prevalence of hepatitis C and B virus among patients infected with HIV: a cross-sectional analysis of a large HIV care programme in Myanmar.

    Science.gov (United States)

    Zaw, Sai Ko Ko; Tun, Sai Thein Than; Thida, Aye; Aung, Thet Ko; Maung, Win; Shwe, Myint; Aye, Mar Mar; Clevenbergh, Phillipe

    2013-07-01

    Co-infection with the hepatitis C virus (HCV) and/or hepatitis B virus (HBV) influences the morbidity and mortality of patients with HIV. A cross sectional analysis was of 11,032 HIV-infected patients enrolled in the Integrated HIV Care Program from May 2005 to April 2012 and Epi-info 3.5 was used to determine the serological prevalence of chronic hepatitis B and hepatitis C. The mean ± standard deviation age of patients was 36 ± 8.4 years (adult cohort) and 7 ± 3 years (paediatric cohort). The sero prevalence of hepatitis B surface antigen, hepatitis C (anti HCV antibodies) and triple infection are 8.7%, 5.3% and 0.35%, respectively. Men who have sex with men are at the highest risk of being co-infected with hepatitis B while intravenous drug users are at the highest risk of being co-infected with hepatitis C. It is important to screen for hepatitis B and C in HIV infected people in order to provide quality care for HIV patients with co-infection.

  16. Falling through the gaps: how should HIV programmes respond to families that persistently deny treatment to children?

    Science.gov (United States)

    Busza, Joanna; Strode, Ann; Dauya, Ethel; Ferrand, Rashida A

    2016-01-01

    Children living with HIV rely on adult caregivers for access to HIV testing and care, including clinical monitoring and adherence to treatment. Yet, many caregivers confront barriers to ensuring children's care, including fear of disclosure of the child's or the parents' HIV status, competing family demands, fluctuating care arrangements and broader structural factors such as entrenched poverty or alternative beliefs about HIV's aetiology and treatment. Thus, many children are "falling through the gaps" because their access to testing and care is mediated by guardians who appear unable or unwilling to facilitate it. These children are likely to suffer treatment failure or death due to their caregivers' recalcitrance. This Commentary presents three cases from paediatric HIV services in Zimbabwe that highlight the complexities facing health care providers in providing HIV testing and care to children, and discusses the implications as a child's rights issue requiring both legal and programmatic responses. The cases provide examples of how disagreements between family members about appropriate care, conflicts between a child and caregiver and religious objections to medical treatment interrupt children's engagement with HIV services. In all three cases, no social or legal mechanisms were in place for health staff to intervene and prevent "loss to follow up." We suggest that conceptualizing this as a child's rights issue may be a useful way to raise the debate and move towards improved treatment access. Our cases reflect policy failure to facilitate access to children's HIV testing and treatment, and are likely to be similar across international settings. We propose sharing experiences and encouraging dialogue between health practitioners and global advocates for children's right to health to raise awareness that children are the bearers of rights even if they lack legal capacity, and that the failure of either the state or their caregiver to facilitate access to care

  17. Admission characteristics, diagnoses and outcomes of HIV-infected patients registered in an ambulatory HIV-care programme in western Kenya.

    Science.gov (United States)

    Siika, A M; Ayuo, P O; Sidle, Mwangi J E; Wools-Kaloustian, K; Kimaiyo, S N; Tierney, W M

    2008-11-01

    To determine admissions diagnosis and outcomes of HIV-infected patients attending AMPATH ambulatory HIV-care clinics. Prospective cohort study. Academic Model for Prevention and Treatment of HIV/ AIDS (AMPATH) ambulatory HIV-care clinic in western Kenya. Between January 2005 and December 2006, 495 HIV-infected patients enrolled in AMPATH were admitted. Median age at admission was 38 years (range: 19-74), 62% females, 375 (76%) initiated cART a median 56 days (range: 1-1288) before admission. Majority (53%) had pre-admission CD4 counts 200 cells/ml. Common admissions diagnoses were: tuberculosis (27%); pneumonia (15%); meningitis (11%); diarrhoea (11%); malaria (6%); severe anaemia (4%); and toxoplasmosis (3%). Deaths occurred in 147 (30%) patients who enrolled at AMPATH a median 44 days (range: 1-711) before admission and died a median 41 days (range: 1-713) after initiating cART. Tuberculosis (27%) and meningitis (14%) were the most common diagnoses in the deceased. Median admission duration was six days (range: 1-30) for deceased patients and eight days (range: 1-44) for survivors (P=0.0024). Deceased patients enrolled in AMPATH or initiated cART more recently, had lower CD4 counts and were more frequently lost to follow-up than survivors (P<0.05 for each comparison). Initiation of cART before admission and clinic appointment adherence were independent predictors of survival. Although high mortality rate is seen in HIV-infected in-patients, those initiating cART before admission were more likely to survive.

  18. Place prioritization for biodiversity content

    Indian Academy of Sciences (India)

    The prioritization of places on the basis of biodiversity content is part of any systematic biodiversity conservation planning process. The place prioritization procedure implemented in the ResNet software package is described. This procedure is primarily based on the principles of rarity and complementarity. Application of the ...

  19. Self-Prioritization Beyond Perception.

    Science.gov (United States)

    Schäfer, Sarah; Wentura, Dirk; Frings, Christian

    2015-01-01

    Recently, Sui, He, and Humphreys (2012) introduced a new paradigm to measure perceptual self-prioritization processes. It seems that arbitrarily tagging shapes to self-relevant words (I, my, me, and so on) leads to speeded verification times when matching self-relevant word shape pairings (e.g., me - triangle) as compared to non-self-relevant word shape pairings (e.g., stranger - circle). In order to analyze the level at which self-prioritization takes place we analyzed whether the self-prioritization effect is due to a tagging of the self-relevant label and the particular associated shape or due to a tagging of the self with an abstract concept. In two experiments participants showed standard self-prioritization effects with varying stimulus features or different exemplars of a particular stimulus-category suggesting that self-prioritization also works at a conceptual level.

  20. Mortality and loss to programme before antiretroviral therapy among HIV-infected children eligible for treatment in The Gambia, West Africa

    Directory of Open Access Journals (Sweden)

    Okomo Uduak

    2012-10-01

    Full Text Available Abstract Background HIV infection among children, particularly those under 24 months of age, is often rapidly progressive; as a result guidelines recommend earlier access to combination antiretroviral therapy (cART for HIV infected children. Losses to follow-up (LTFU and death in the interval between diagnosis and initiation of ART profoundly limit this strategy. This study explores correlates of LTFU and death prior to ART initiation among children. Methods The study is based on 337 HIV-infected children enrolled into care at an urban centre in The Gambia, including those alive and in care when antiretroviral therapy became available and those who enrolled later. Children were followed until they started ART, died, transferred to another facility, or were LTFU. Cox proportional hazards regression models were used to determine the hazard of death or LTFU according to the baseline characteristics of the children. Results Overall, 223 children were assessed as eligible for ART based on their clinical and/or immunological status among whom 73 (32.7% started treatment, 15 (6.7% requested transfer to another health facility, 105 (47.1% and 30 (13.5% were lost to follow-up and died respectively without starting ART. The median survival following eligibility for children who died without starting treatment was 2.8 months (IQR: 0.9 - 5.8 with over half (60% of all deaths occurring at home. ART-eligible children less than 2 years of age and those in WHO stage 3 or 4 were significantly more likely to be LTFU when compared with their respective comparison groups. The overall pre-treatment mortality rate was 25.7 per 100 child-years of follow-up (95% CI 19.9 - 36.8 and the loss to programme rate was 115.7 per 100 child-years of follow-up (95% CI 98.8 - 137. In the multivariable Cox proportional hazard model, significant independent predictors of loss to programme were being less than 2 years of age and WHO stage 3 or 4. The Adjusted Hazard Ratio

  1. Peer mentors, mobile phone and pills: collective monitoring and adherence in Kenyatta National Hospital's HIV treatment programmeospital’s HIV treatment programme

    NARCIS (Netherlands)

    Moyer, E.

    2014-01-01

    In 2006, the Kenyan state joined the international commitment to make antiretroviral treatment free in public health institutions to people infected with HIV. Less than a decade later, treatment has reached over 60% of those who need it in Kenya. This paper, which is based on an in-depth

  2. Epidemiological trends of HIV/AIDS in Pakistan: a twelve year experience at the national AIDS Programme

    International Nuclear Information System (INIS)

    Kazi, B.M.; Saleem, M.; Salman, M.; Bokhari, A.

    1999-01-01

    A total of 23,40,000 blood samples were screened for the presence of antibodies against Human Immunodeficiency Virus (HIV) at various officially designated surveillance and diagnostic centers throughout the country, during the period of 12 years extending from 1986 to 1999. The reported positive cases screened before blood transfusion under the initiative launched in public sector hospitals during 1995 are also included in the total figure. A total of 1395 as symptomatic persons have been diagnosed and reported as HIV positive whereas 178 persons with signs and symptoms of full blown AIDS have been diagnosed. The tests were performed on selected categories of persons and include; persons with risky behavior, patients with sexually transmitted disease, professional blood donors, blood and blood product recipients intravenous drug injectors, patients with tuberculosis, women attending antenatal clinics, long distance drivers, and seaman. Apart from these identified groups, referred patients from the public and private hospitals, laboratories, clinics, nursing homes and HIV positive. The male to female ratio for HIV positive and AIDS cases as 7:1 and 8:1 respectively. Most of the cases acquired the disease through sexual contact including hetro, Homo and bisexual modes of transmission. Maximum numbers of the HIV positive individuals are between the age's 20-29 years. The data gives an overall prevalence rate of 0.07% which, although looking low, still deserves serious attention in view of system anomalies relating and under reporting and very long incubation period of the disease. (author)

  3. Prioritizing like nuclear smugglers

    Energy Technology Data Exchange (ETDEWEB)

    Erickson, S A

    1999-07-01

    An individual or group attempting to smuggle nuclear material out of a country has a choice of what border crossing to use and how to do it. If it is possible to think like a smuggler and determine what preferences one would have, then we could protect those smuggler-preferred border crossings first. Thinking like a smuggler requires that one understand a host of things: who is likely to smuggle and what might they have obtained, where they might have gotten it, and where they would like to deliver or sell it, how they will attempt to pass customs, how they might travel on both sides of the border, and what influences they might have on customs officials. After collecting data on criminology, geography, and much else, it is necessary to paste the data together into scenarios to ensure that self-consistent smuggling plans are created. These lead to counter-smuggling opportunities. Smuggling by amateurs turns out to be of a different class than professional smuggling, and needs to be countered differently. This work also assists in formulating key policy questions useful to guide counter-smuggling efforts. This methodology was developed for DOE/NN-43 for assistance with prioritization within the Second Line of Defense program.

  4. Prioritizing like nuclear smugglers

    International Nuclear Information System (INIS)

    Erickson, S.A.

    1999-01-01

    An individual or group attempting to smuggle nuclear material out of a country has a choice of what border crossing to use and how to do it. If it is possible to think like a smuggler and determine what preferences one would have, then we could protect those smuggler-preferred border crossings first. Thinking like a smuggler requires that one understand a host of things: who is likely to smuggle and what might they have obtained, where they might have gotten it, and where they would like to deliver or sell it, how they will attempt to pass customs, how they might travel on both sides of the border, and what influences they might have on customs officials. After collecting data on criminology, geography, and much else, it is necessary to paste the data together into scenarios to ensure that self-consistent smuggling plans are created. These lead to counter-smuggling opportunities. Smuggling by amateurs turns out to be of a different class than professional smuggling, and needs to be countered differently. This work also assists in formulating key policy questions useful to guide counter-smuggling efforts. This methodology was developed for DOE/NN-43 for assistance with prioritization within the Second Line of Defense program

  5. Assessment of an outreach street-based HIV rapid testing programme as a strategy to promote early diagnosis: a comparison with two surveillance systems in Spain, 2008-2011.

    Science.gov (United States)

    Belza, M J; Hoyos, J; Fernández-Balbuena, S; Diaz, A; Bravo, M J; de la Fuente, L

    2015-04-09

    We assess the added value of a multisite, street-based HIV rapid testing programme by comparing its results to pre-existing services and assessing its potential to reduce ongoing transmission. Between 2008 and 2011, 8,923 individuals underwent testing. We compare outcomes with those of a network of 20 sexually transmitted infections (STI)/HIV clinics (EPI-VIH) and the Spanish National HIV Surveillance System (SNHSS); evaluate whether good visibility prompts testing and assess whether it reaches under-tested populations. 89.2% of the new infections were in men who have sex with men (MSM) vs 78.0% in EPI-VIH and 56.0% in SNHSS. 83.6% of the MSM were linked to care and 20.9% had VIH. 56.5% of the HIV-positive MSM tested because they happened to see the programme, 18.4% were previously untested and 26.3% had their last test ≥2 years ago. The programme provided linkage to care and early diagnosis mainly to MSM but attendees presented a lower HIV prevalence than EPI-VIH. From a cost perspective it would benefit from being implemented in locations highly frequented by MSM. Conversely, its good visibility led to reduced periods of undiagnosed infection in a high proportion of MSM who were not testing with the recommended frequency.

  6. Self-care practices and experiences of people living with HIV not receiving antiretroviral therapy in an urban community of Lusaka, Zambia: implications for HIV treatment programmes

    Science.gov (United States)

    2013-01-01

    Background Despite the increasingly wider availability of antiretroviral therapy (ART), some people living with HIV (PLHIV) and eligible for treatment have opted to adopt self-care practices thereby risking early AIDS-related mortality. Methods A qualitative study was conducted in urban Zambia to gain insights into PLHIV self-care practices and experiences and explore the implications for successful delivery of ART care. Between March 2010 and September 2011, in-depth interviews were conducted with PLHIV who had dropped out of treatment (n=25) and those that had opted not to initiate medication (n=37). Data was entered into and managed using Atlas ti, and analysed inductively using latent content analysis. Results PHIV used therapeutic and physical health maintenance, psychological well-being and healthy lifestyle self-care practices to maintain physical health and mitigate HIV-related symptoms. Herbal remedies, faith healing and self-prescription of antibiotics and other conventional medicines to treat HIV-related ailments were used for therapeutic and physical health maintenance purposes. Psychological well-being self-care practices used were religiosity/spirituality and positive attitudes towards HIV infection. These practices were modulated by close social network relationships with other PLHIV, family members and peers, who acted as sources of emotional, material and financial support. Cessations of sexual relationships, adoption of safe sex to avoid re-infections and uptake of nutritional supplements were the commonly used risk reduction and healthy lifestyle practices respectively. Conclusions While these self-care practices may promote physical and psychosocial well-being and mitigate AIDS-related symptoms, at least in the short term, they however undermine PLHIV access to ART care thereby putting PLHIV at risk of early AIDS-related mortality. The use of scientifically unproven herbal remedies raises health and safety concerns; faith healing may create

  7. A prioritization of research activities

    International Nuclear Information System (INIS)

    Pittman, J.W.

    1988-12-01

    This report presents the results of the efforts in prioritizing the activities in the Office of Research. The purpose of this prioritization is to provide a basis on which to make management decisions. The report describes also the methodology and criteria upon which the priority rankings are based. Each activity was evaluated against four attributes. These attributes are: safety assurance, usefulness, appropriateness and resources. This report will be periodically revised to include the prioritization of new activities, deletion of completed activities and to reflect changes in budget allocations and projections. 3 refs., 5 figs

  8. The Effectiveness of HIV/AIDS School-Based Sexual Health Education Programmes in Nigeria: A Systematic Review

    Science.gov (United States)

    Amaugo, Lucky Gospel; Papadopoulos, Chris; Ochieng, Bertha M. N.; Ali, Nasreen

    2014-01-01

    HIV/AIDS is one of the most important public health challenges facing Nigeria today. Recent evidence has revealed that the adolescent population make up a large proportion of the 3.7% reported prevalence rate among Nigerians aged 15-49 years. School-based sexual health education has therefore become an important tool towards fighting this problem.…

  9. Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information.

    Science.gov (United States)

    Gloyd, Stephen; Wagenaar, Bradley H; Woelk, Godfrey B; Kalibala, Samuel

    2016-01-01

    HIV programme data from routine health information systems (RHIS) and personal health information (PHI) provide ample opportunities for secondary data analysis. However, these data pose unique opportunities and challenges for use in health system monitoring, along with process and impact evaluations. Analyses focused on retrospective case reviews of four of the HIV-related studies published in this JIAS supplement. We identify specific opportunities and challenges with respect to the secondary analysis of RHIS and PHI data. Challenges working with both HIV-related RHIS and PHI included missing, inconsistent and implausible data; rapidly changing indicators; systematic differences in the utilization of services; and patient linkages over time and different data sources. Specific challenges among RHIS data included numerous registries and indicators, inconsistent data entry, gaps in data transmission, duplicate registry of information, numerator-denominator incompatibility and infrequent use of data for decision-making. Challenges specific to PHI included the time burden for busy providers, the culture of lax charting, overflowing archives for paper charts and infrequent chart review. Many of the challenges that undermine effective use of RHIS and PHI data for analyses are related to the processes and context of collecting the data, excessive data requirements, lack of knowledge of the purpose of data and the limited use of data among those generating the data. Recommendations include simplifying data sources, analysis and reporting; conducting systematic data quality audits; enhancing the use of data for decision-making; promoting routine chart review linked with simple patient tracking systems; and encouraging open access to RHIS and PHI data for increased use.

  10. Neutrosophy for software requirement prioritization

    Directory of Open Access Journals (Sweden)

    Ronald Barriga Dias

    2017-09-01

    Full Text Available Software engineers are involved in complex decisions that require multiples viewpoints. A specific case is the requirement prioritization process. This process is used to decide which software requirement to develop in certain release from a group of candidate requirements. Criteria involved in this process can involve indeterminacy. In this paper a software requirement prioritization model is develop based SVN numbers. Finally, an illustrative example is presented in order to show the proposed model.

  11. Piloting a national laboratory electronic programme status reporting ...

    African Journals Online (AJOL)

    the Comprehensive Care, Management and Treatment of HIV and. AIDS (CCMT) programme .... NHLS Laboratory Information System (LIS) to facilitate the data ..... HIV clinical and program outcomes among older patients with HIV enrolled in ...

  12. Strategies for reducing police arrest in the context of an HIV prevention programme for female sex workers: evidence from structural interventions in Karnataka, South India.

    Science.gov (United States)

    Bhattacharjee, Parinita; Isac, Shajy; McClarty, Leigh M; Mohan, Haranahalli L; Maddur, Srinath; Jagannath, Sunitha B; Venkataramaiah, Balasubramanya K; Moses, Stephen; Blanchard, James F; Gurnani, Vandana

    2016-01-01

    Female sex workers (FSWs) frequently experience violence in their work environments, violating their basic rights and increasing their vulnerability to HIV infection. Structural interventions addressing such violence are critical components of comprehensive HIV prevention programmes. We describe structural interventions developed to address violence against FSWs in the form of police arrest, in the context of the Bill and Melinda Gates Foundation's India AIDS Initiative (Avahan) in Karnataka, South India. We examine changes in FSW arrest between two consecutive time points during the intervention and identify characteristics that may increase FSW vulnerability to arrest in Karnataka. Structural interventions with police involved advocacy work with senior police officials, sensitization workshops, and integration of HIV and human rights topics in pre-service curricula. Programmes for FSWs aimed to enhance collectivization, empowerment and awareness about human rights and to introduce crisis response mechanisms. Three rounds of integrated behavioural and biological assessment surveys were conducted among FSWs from 2004 to 2011. We conducted bivariate and multivariate analyses using data from the second (R2) and third (R3) survey rounds to examine changes in arrests among FSWs over time and to assess associations between police arrest, and the sociodemographic and sex work-related characteristics of FSWs. Among 4110 FSWs surveyed, rates of ever being arrested by the police significantly decreased over time, from 9.9% in R2 to 6.1% in R3 (adjusted odds ratio (AOR) [95% CI]=0.63 [0.48 to 0.83]). Arrests in the preceding year significantly decreased, from 5.5% in R2 to 2.8% in R3 (AOR [95% CI]=0.59 [0.41 to 0.86]). FSWs arrested as part of arbitrary police raids also decreased from 49.6 to 19.5% (AOR [95% CI]=0.21 [0.11 to 0.42]). Certain characteristics, including financial dependency on sex work, street- or brothel-based solicitation and high client volumes, were found

  13. Clinical setting-based smoking cessation programme and the quality of life in people living with HIV in Austria and Germany.

    Science.gov (United States)

    Grabovac, Igor; Brath, Helmut; Schalk, Horst; Degen, Olaf; Dorner, Thomas E

    2017-09-01

    To report on the global quality of life (QOL) in people living with HIV (PLWHIV) and how a smoking cessation intervention influences the changes in QOL. Participants were asked to fill out a questionnaire during visits to their HIV outpatient clinic consisting of sociodemographic information, general health data and the WHOQOL HIV-Bref. Exhaled carbon monoxide measurements were used to confirm the smoking status, based on which participants classified as smokers received a short 5 min structured intervention and were offered participation in a full smoking cessation programme consisting of five sessions. Follow-up was done 8 months after the baseline. Overall 447 (mean age = 45.5) participants took part with 221 being classified as smokers. A total of 165 (74.6%) participants received a short intervention and 63 (29.4%) agreed to participate in the full program. At baseline, differences in QoL were observed, where smokers had lower QoL in domains of physical (M = 16.1 vs. 15.3, p = 0.009) and psychological (M = 15.3 vs. 14.6, p = 0.021) well-being, independency level (M = 16.1 vs. 15.2, p = 0.003) and environment (M = 16.5 vs. 16.0, p = 0.036). At study end, 27 (12.2%) participants quit smoking; 12 (19.0%) participants of the full programme and 15 (14.7%) that received the short intervention. There were no significant differences in QoL between those that continued to smoke and quitters at follow-up. Quality of life results may be used to better understand the underlying motivation of PLWHIV who start cessation programs. In order to reduce the high prevalence and health burden that smoking causes in PLWHIV, it is necessary to introduce effective interventions that can be used in the clinical settings.

  14. Mapping evidence of interventions and strategies to bridge the gap in the implementation of the prevention of mother-to-child transmission of HIV programme policy in sub-Saharan countries: A scoping review.

    Science.gov (United States)

    Ngidi, Wilbroda H; Naidoo, Joanne R; Ncama, Busisiwe P; Luvuno, Zamasomi P B; Mashamba-Thompson, Tivani P

    2017-05-29

    Prevention of mother-to-child transmission (PMTCT) of HIV is a life-saving public health intervention. Sub-Saharan African (SSA) countries have made significant progress in the programme, but little is known about the strategies used by them to eliminate mother-to-child transmission of HIV. To map evidence of strategies and interventions employed by SSA in bridging the implementation gap in the rapidly changing PMTCT of HIV programme policy. Electronic search of the databases MEDLINE, PubMed and SABINET for articles published in English between 2001 and August 2016. Key words included 'Sub-Saharan African countries', 'implementation strategies', 'interventions to bridge implementation gap', 'prevention of mother-to-child transmission of HIV' and 'closing implementation gap'. Of a total of 743 articles, 25 articles that met the inclusion criteria were included in the study. Manual content analysis resulted in the identification of three categories of strategies: (1) health system (referral systems, integration of services, supportive leadership, systematic quality-improvement approaches that vigorously monitors programme performance); (2) health service delivery (task shifting, networking, shared platform for learning, local capacity building, supportive supervision); as well as (3) community-level strategies (community health workers, technology use - mHealth, family-centred approaches, male involvement, culturally appropriate interventions). There are strategies that exist in SSA countries. Future research should examine multifaceted scientific models to prioritise the highest impact and be evaluated for effectiveness and efficiency.

  15. Monitoring and evaluation of sport-based HIV/ AIDS awareness ...

    African Journals Online (AJOL)

    ... HIV/ AIDS awareness programmes: Strengthening outcome indicators. ... within the key priorities highlighted in the current National Strategic Plan for HIV/AIDS, ... of HIV/AIDS and change in attitude and intention towards HIV risk behaviours.

  16. Development of Nevirapine Resistance in Children Exposed to the Prevention of Mother-to-Child HIV-1 Transmission Programme in Maputo, Mozambique.

    Directory of Open Access Journals (Sweden)

    Francisco Antunes

    Full Text Available Single-dose nevirapine (sd-NVP has been the main option for prevention of mother-to-child transmission (PMTCT of HIV-1 in low-resource settings. However, sd-NVP can induce the selection of HIV-1 resistant mutations in mothers and infants. In Mozambique, there are limited data regarding the profile of NVP resistance associated mutations (RAM in the context of PMTCT.To assess the prevalence and the factors associated with NVP RAM among children born to HIV-1 infected mothers enrolled in the PMTCT programme adopted in Mozambique.One hundred and fifty seven children aged 6 to 48 weeks were sequentially included (July 2011 to March 2012 at four centres in Maputo. Genotyping of RAM was performed in samples with HIV-1 RNA≥ 100 copies/μL (Viroseq. Sequencing was performed with ABI 3100 (Applied Biosystems. Logistic regression modelling was undertaken to identify the factors associated with NVP RAM.Seventy-nine children had their samples genotyped. Their median age was 7.0 (3-12 months and 92.4% received prophylaxis with sd-NVP at birth plus daily NVP. 35.4% of mothers received antiretrovirals (ARVs for PMTCT. ARV RAM were detected in 43 (54.4% of the children. 45.6% of these children had at least one NVP RAM. The most common mutations associated with NVP resistance were K103N (n = 16 and Y181C (n = 15. NVP RAM was significantly associated with mother exposure to PMTCT (crude odds ratio [OR] 30.3, 95% CI 4.93-186.34 and with mother's CD4 count < 350 cells/mm3 (crude OR 3.08, 95% CI 1.02-9.32. In the multivariable analysis the mother's exposure to PMTCT was the only variable significantly associated with NVP RAM (adjusted OR 48.65, 95% CI 9.33-253.66.We found a high prevalence of NVP RAM among children who were exposed to the drug regimen for PMTCT in Mozambique. The mothers' exposure to PMTCT significantly increased the risk of NVP RAM.

  17. Quality of antenatal and delivery care before and after the implementation of a prevention of mother-to-child HIV transmission programme in Côte d'Ivoire.

    Science.gov (United States)

    Delvaux, Thérèse; Konan, Jean-Paul Diby; Aké-Tano, Odile; Gohou-Kouassi, Valérie; Bosso, Patrice Emery; Buvé, Anne; Ronsmans, Carine

    2008-08-01

    To assess whether implementation of a prevention of mother-to-child HIV transmission (PMTCT) programme in Côte d'Ivoire improved the quality of antenatal and delivery care services. Quality of antenatal and delivery care services was assessed in five urban health facilities before (2002-2003) and after (2005) the implementation of a PMTCT programme through review of facility data; observation of antenatal consultations (n = 606 before; n = 591 after) and deliveries (n = 229 before; n = 231 after) and exit interviews of women; and interviews of health facility staff. HIV testing was never proposed at baseline and was proposed to 63% of women at the first ANC visit after PMTCT implementation. The overall testing rate was 42% and 83% of tested HIV-infected pregnant women received nevirapine. In addition, inter-personal communication and confidentiality significantly improved in all health facilities. In the maternity ward, quality of obstetrical care at admission, delivery and post-partum care globally improved in all facilities after the implementation of the programme although some indicators remained poor, such as filling in the partograph directly during labour. Episiotomy rates among primiparous women dropped from 64% to 25% (P implementation. Global scores for quality of antenatal and delivery care significantly improved in all facilities after the implementation of the programme. Introducing comprehensive PMTCT services can improve the quality of antenatal and delivery care in general.

  18. The funding landscape for HIV in Asia and the Pacific

    Science.gov (United States)

    Stuart, Robyn M; Lief, Eric; Donald, Braedon; Wilson, David; Wilson, David P

    2015-01-01

    Introduction Despite recent and robust economic growth across the Asia-Pacific region, the majority of low- and middle-income countries in the region remain dependent on some donor support for HIV programmes. We describe the availability of bilateral and multilateral official development assistance (ODA) for HIV programmes in the region. Methods The donor countries considered in this analysis are Australia, Canada, Denmark, France, Germany, Netherlands, Norway, Sweden, the United Kingdom and the United States. To estimate bilateral and multilateral ODA financing for HIV programmes in the Asia-Pacific region between 2004 and 2013, we obtained funding data from the Organisation for Economic Co-operation and Development Creditor Reporting System database. Where possible, we checked these amounts against the funding data available from government aid agencies. Estimates of multilateral ODA financing for HIV/AIDS were based on the country allocations announcement by the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund) for the period 2014 to 2016. Results Countries in the Asia-Pacific region receive the largest share of aid for HIV from the Global Fund. Bilateral funding for HIV in the region has been relatively stable over the last decade and is projected to remain below 10% of the worldwide response to the epidemic. Bilateral donors continue to prioritize ODA for HIV to other regions, particularly sub-Saharan Africa; Australia is an exception in prioritizing the Asia-Pacific region, but the United States is the bilateral donor providing the greatest amount of assistance in the region. Funding from the Global Fund has increased consistently since 2005, reaching a total of US$1.2 billion for the Asia-Pacific region from 2014 to 2016. Conclusions Even with Global Fund allocations, countries in the Asia-Pacific region will not have enough resources to meet their epidemiological targets. Prevention funding is particularly vulnerable and requires greater

  19. The effectiveness of the government's HIV/AIDS programme and condom use among educators / Mahadi Audrey Mansfield

    OpenAIRE

    Mansfield, Mahadi Audrey

    2010-01-01

    As South Africa is one of the countries with the highest HIV/Aids prevalence in the world, many South Africans are affected by the pandemic. The education system is one of the structures that cannot escape the effects of the pandemic. Educators are especially affected by the pandemic due to the fact that they not only have to cope with the infected colleagues who are often absent, but are also burdened with numerous orphans and vulnerable children at their schools because of the pandemic. Som...

  20. Male circumcision for HIV prevention: current evidence and implementation in sub-Saharan Africa

    Science.gov (United States)

    2011-01-01

    Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major role in HIV transmission in sub-Saharan Africa. Here, we provide a critical evaluation of the state of the current evidence for male circumcision in reducing HIV infection in light of established transmission drivers, provide an update on programmes now in place in this region, and explain why policies based on established scientific evidence should be prioritized. We conclude that the evidence supports the need to accelerate the implementation of medical male circumcision programmes for HIV prevention in generalized heterosexual epidemics, as well as in countering the growing heterosexual transmission in countries where HIV prevalence is presently low. PMID:22014096

  1. The Recent Infection Testing Algorithm (RITA) in clinical practice: a survey of HIV clinicians in England and Northern Ireland.

    Science.gov (United States)

    Garrett, Nj; Lattimore, S; Gilbart, Vl; Aghaizu, A; Mensah, G; Tosswill, J; Murphy, G; Delpech, V

    2012-08-01

    In order to estimate HIV incidence among high-risk groups, in January 2009 the Health Protection Agency introduced the Recent Infection Testing Algorithm (RITA) in England and Northern Ireland (E&NI), currently the only regions to inform patients of RITA results. This survey of HIV specialists aimed to investigate the role of RITA in patient management and explore clinicians' views on its role in clinical practice and during partner notification. An online questionnaire was distributed to HIV specialists via the British HIV Association membership email list in February 2011. Forty-two HIV specialists from 32 HIV centres responded to the survey among 90 centres enrolled in the programme (response rate 36%). Testing for recent infection was considered standard of care by 83% of respondents, 80% felt confident in interpreting results and 92% discussed results with patients, particularly in the context of a possible HIV seroconversion illness (96%) or when deciding when to start antiretroviral therapy (70%). A third (36%) of specialists were initially concerned that RITA results may cause additional anxiety among patients; however, no adverse events were reported. The majority (90%) felt that results could assist with contact tracing by prioritizing patients with likely recent infection. However, only a few centres have currently incorporated RITA into their HIV partner notification protocols. RITA has been introduced into clinical practice with no reported patient adverse events. Access to results at centre level should be improved. National guidance regarding use of RITA as a tool for contact tracing is required. © 2012 British HIV Association.

  2. The Happy Teen programme: a holistic outpatient clinic-based approach to prepare HIV-infected youth for the transition from paediatric to adult medical care services in Thailand.

    Science.gov (United States)

    Lolekha, Rangsima; Boon-Yasidhi, Vitharon; Na-Nakorn, Yossawadee; Manaboriboon, Boonying; Vandepitte, Warunee Punpanich; Martin, Michael; Tarugsa, Jariya; Nuchanard, Wipada; Leowsrisook, Pimsiri; Lapphra, Ketwadee; Suntarattiwong, Piyarat; Thaineua, Vorapathu; Chokephaibulkit, Kulkanya

    2017-05-16

    We developed an 18-month Happy Teen 2 (HT2) programme comprised of a one-day workshop, two half-day sessions, and three individual sessions to prepare HIV-infected youth for the transition from paediatric to adult HIV care services. We describe the programme and evaluate the change in youth's knowledge scores. We implemented the HT2 programme among HIV-infected Thai youth aged 14-22 years who were aware of their HIV status and receiving care at two hospitals in Bangkok (Siriraj Hospital, Queen Sirikit National Institute of Child Health [QSNICH]). Staff interviewed youth using a standardized questionnaire to assess HIV and health-related knowledge at baseline and at 12 and 18 months while they participated in the programme. We examined factors associated with a composite knowledge score ≥95% at month 18 using logistic regression. During March 2014-July 2016, 192 of 245 (78%) eligible youth were interviewed at baseline. Of these, 161 (84%) returned for interviews at 12 and 18 months. Among the 161 youth, the median age was 17 years, 74 (46%) were female, and 99% were receiving antiretroviral treatment. The median composite score was 45% at baseline and increased to 82% at 12 months and 95% at 18 months ( P  95% was associated with education level >high school (aOR: 2.15, 95%CI, 1.03-4.48) and receipt care at QSNICH (aOR: 2.43, 95%CI, 1.18-4.98). Youth whose mother and father had died were less likely to have score ≥95% (aOR: 0.22, 95%CI, 0.07-0.67) than those with living parents. Knowledge useful for a successful transition from paediatric to adult HIV care increased among youth participating in the HT2 programme. Youth follow-up will continue to assess the impact of improved knowledge on outcomes following the transition to adult care services.

  3. Using Intervention Mapping to develop a programme to prevent sexually transmittable infections, including HIV, among heterosexual migrant men

    Science.gov (United States)

    Wolfers, Mireille EG; van den Hoek, Caty; Brug, Johannes; de Zwart, Onno

    2007-01-01

    Background There is little experience with carefully developed interventions in the HIV/STI prevention field aimed at adult heterosexual target groups in the Netherlands. The ability to apply intervention development protocols, like Intervention Mapping, in daily practice outside of academia, is a matter of concern. An urgent need also exists for interventions aimed at the prevention of STI in migrant populations in the Netherlands. This article describes the theory and evidence based development of HIV/STI prevention interventions by the Municipal Public Health Service Rotterdam Area (MPHS), the Netherlands, for heterosexual migrant men with Surinamese, Dutch-Caribbean, Cape Verdean, Turkish and Moroccan backgrounds. Methods First a needs assessment was carried out. Then, a literature review was done, key figures were interviewed and seven group discussions were held. Subsequently, the results were translated into specific objectives ("change objectives") and used in intervention development for two subgroups: men with an Afro-Caribbean background and unmarried men with a Turkish and Moroccan background. A matrix of change objectives was made for each subgroup and suitable theoretical methods and practical strategies were selected. Culturally-tailored interventions were designed and were pre-tested among the target groups. Results This development process resulted in two interventions for specific subgroups that were appreciated by both the target groups and the migrant prevention workers. The project took place in collaboration with a university center, which provided an opportunity to get expert advice at every step of the Intervention Mapping process. At relevant points of the development process, migrant health educators and target group members provided advice and feedback on the draft intervention materials. Conclusion This intervention development project indicates that careful well-informed intervention development using Intervention Mapping is feasible in

  4. Developing optimized prioritizing road maintenance

    Directory of Open Access Journals (Sweden)

    Ewadh Hussein Ali

    2018-01-01

    Full Text Available Increased demand for efficient maintenance of the existing roadway system needs optimal usage of the allocated funds. The paper demonstrates optimized methods for prioritizing maintenance implementation projects. A selected zone of roadway system in Kerbala city represents the study area to demonstrate the application of the developed prioritization process. Paver system PAVER integrated with GIS is used to estimate and display the pavement condition index PCI, thereby to establish a priority of maintenance. In addition to simple ranking method by PCI produced by the output of PAVER, the paper introduces PCI measure for each section of roadway. The paper introduces ranking by multiple measures investigated through expert knowledge about measures that affect prioritization and their irrespective weights due to a predesigned questionnaire. The maintenance priority index (MPI is related to cost of suitable proposed maintenance, easiness of proposed maintenance, average daily traffic and functional classification of the roadway in addition to PCI. Further, incremental benefit-cost analysis ranking provide an optimized process due to benefit and cost of maintenance. The paper introduces efficient display of layout and ranking for the selected zone of roadway system based on MPI index and incremental BCR method. Although the two developed methods introduce different layout display for priority, statistical test shows that no significant difference between ranking of all methods of prioritization.

  5. Prioritization of generic safety issues

    International Nuclear Information System (INIS)

    Emrit, R.; Minners, W.; VanderMolen, H.

    1983-12-01

    This report presents the priority rankings for generic safety issues related to nuclear power plants. The purpose of these rankings is to assist in the timely and efficient allocation of NRC resources for the resolution of those safety issues that have a significant potential for reducing risk. The report focuses on the prioritization of generic safety issues. Issues primarily concerned with the licensing process or environmental protection and not directly related to safety have been excluded from prioritization. The prioritized issues include: TMI Action Plan items under development; previously proposed issues covered by Task Action Plans, except issues designated at Unresolved Safety Issues (USIs) which had already been assigned high priority; and newly-proposed issues. Future supplements to this report will include the prioritization of additional issues. The safety priority rankings are HIGH, MEDIUM, LOW, and DROP and have been assigned on the basis of risk significance estimates, the ratio of risk to costs and other impacts estimated to result if resolutions of the safety issues were implemented, and the consideration of uncertainties and other quantitative or qualitative factors. To the extent practical, estimates are quantitative

  6. Assessing spatial patterns of HIV knowledge in rural Mozambique using geographic information systems.

    Science.gov (United States)

    Buehler, Charlotte P; Blevins, Meridith; Ossemane, Ezequiel B; González-Calvo, Lázaro; Ndatimana, Elisée; Vermund, Sten H; Sidat, Mohsin; Olupona, Omo; Moon, Troy D

    2015-03-01

    To conduct a cross-sectional mapping analysis of HIV knowledge in Zambézia Province, Mozambique, and to examine spatial patterns of HIV knowledge and associated household characteristics. A population-based cluster survey was administered in 2010; data were analysed from 201 enumeration areas in three geographically diverse districts: Alto Molócuè, Morrumbala and Namacurra. We assessed HIV knowledge scores (0-9 points) using previously validated assessment tools. Using geographic information systems (GIS), we mapped hot spots of high and low HIV knowledge. Our multivariable linear regression model estimated HIV knowledge associations with distance to nearest clinic offering antiretroviral therapy, respondent age, education, household size, number of children under five, numeracy, literacy and district of residence. We found little overall HIV knowledge in all three districts. People in Alto Molócuè knew comparatively most about HIV, with a median score of 3 (IQR 2-5) and 22 of 51 (43%) enumeration areas scoring ≥4 of 9 points. Namacurra district, closest to the capital city and expected to have the best HIV knowledge levels, had a median score of 1 (IQR 0-3) and only 3 of 57 (5%) enumeration areas scoring ≥4 points. More HIV knowledge was associated with more education, age, household size, numeracy and proximity to a health facility offering antiretroviral therapy. HIV knowledge is critical for its prevention and treatment. By pinpointing areas of poor HIV knowledge, programme planners can prioritize educational resources and outreach initiatives within the context of antiretroviral therapy expansion. © 2014 John Wiley & Sons Ltd.

  7. Process assessment of a peer education programme for HIV prevention among sex workers in Dhaka, Bangladesh : a social support framework.

    Science.gov (United States)

    Sarafian, Isabelle

    2012-08-01

    This study evaluated the process of a peer education program for hotel-based sex workers in Dhaka, Bangladesh, with social support proposed as an organizing framework. Programme outcomes were examined through baseline and follow-up assessments. Sex workers naïve to peer education were assessed on socio-cognitive and behavioural variables; a subsample was reassessed at follow-up 23 weeks later on average. Process was assessed in terms of the content of peer education sessions. These sessions were recorded and coded into percentages of social support types provided by the peer educator to her audience: informational, instrumental, appraisal, emotional, companionship, non-support. Peer educators were classified into three "social support profiles" based on average proportions of emotional and informational support they provided. Seeing more peer educators with a high informational support profile was related to higher sex worker self-efficacy, self-reported STI symptoms, and self-reported condom use at follow-up; the same was true for the high emotional support profile and treatment seeking. Social support constituted a useful framework, but needs further exploration. This study provided a direct, in-depth examination of the process of peer education based on a comprehensive theoretical framework. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Savannah River Site prioritization of transition activities

    International Nuclear Information System (INIS)

    Finley, R.H.

    1993-11-01

    Effective management of SRS conversion from primarily a production facility to other missions (or Decontamination and Decommissioning (D ampersand D)) requires a systematic and consistent method of prioritizing the transition activities. This report discusses the design of a prioritizing method developed to achieve systematic and consistent methods of prioritizing these activities

  9. Evolution of HIV and AIDS Programmes in an African Institution of Higher Learning: The Case of the Copperbelt University in Zambia

    OpenAIRE

    Sanjobo, Nawa; Lukwesa, Matilda; Kaziya, Charity; Tepa, Cornwell; Puta, Bernard

    2016-01-01

    Background: Universities present the foundation for socio-economic and political development. Without structures and processes to fight HIV, there is no prospect of enhancing treatment, prevention, care and support services. Copperbelt University HIV and AIDS response was initiated in 2003 with the aim of building capacity of students and employees in HIV and AIDS. Objectives: The main objective of this paper is to demonstrate how the CBU HIV response has evolved over time and provide a timel...

  10. Provider-initiated HIV testing & counselling in incident tuberculosis cases under National TB Programme conditions at a tertiary care teaching hospital in Tirupati, south India

    Directory of Open Access Journals (Sweden)

    Alladi Mohan

    2017-01-01

    >Interpretation & conclusions: The findings of this study showed that a higher proportion of TB patients underwent HIV testing (75% compared to the national figure of 63 per cent in 2013-2014. HIV seropositivity (4.6% in TB patients who underwent HIV testing was similar to the five per cent figure observed at national level during 2013-2014. The HIV status of 25 per cent of patients with incident TB still remained unknown, suggesting a need for better integration and co-ordination for effective management of HIV-TB co-infection.

  11. A remedial alternative prioritization method

    International Nuclear Information System (INIS)

    Richter, S.A.; Travis, C.C.

    1987-01-01

    This study develops and tests a technique for evaluating and prioritizing alternative remedial actions for hazardous waste sites. The method is based on criteria involving risk, benefit and cost, and identifies the most cost-effective solution to a given remedial problem. Four sites on the Department of Energy's Oak Ridge National Laboratory (ORNL) property in Oak Ridge, Tennessee, were used in a case study to develop and test the method. Results of the case study indicate that even if the cap providing in situ containment must be replaced every 10 years, it is a superior alternative to total excavation of the waste sites

  12. Prioritization methodology for chemical replacement

    Science.gov (United States)

    Cruit, Wendy; Goldberg, Ben; Schutzenhofer, Scott

    1995-01-01

    Since United States of America federal legislation has required ozone depleting chemicals (class 1 & 2) to be banned from production, The National Aeronautics and Space Administration (NASA) and industry have been required to find other chemicals and methods to replace these target chemicals. This project was initiated as a development of a prioritization methodology suitable for assessing and ranking existing processes for replacement 'urgency.' The methodology was produced in the form of a workbook (NASA Technical Paper 3421). The final workbook contains two tools, one for evaluation and one for prioritization. The two tools are interconnected in that they were developed from one central theme - chemical replacement due to imposed laws and regulations. This workbook provides matrices, detailed explanations of how to use them, and a detailed methodology for prioritization of replacement technology. The main objective is to provide a GUIDELINE to help direct the research for replacement technology. The approach for prioritization called for a system which would result in a numerical rating for the chemicals and processes being assessed. A Quality Function Deployment (QFD) technique was used in order to determine numerical values which would correspond to the concerns raised and their respective importance to the process. This workbook defines the approach and the application of the QFD matrix. This technique: (1) provides a standard database for technology that can be easily reviewed, and (2) provides a standard format for information when requesting resources for further research for chemical replacement technology. Originally, this workbook was to be used for Class 1 and Class 2 chemicals, but it was specifically designed to be flexible enough to be used for any chemical used in a process (if the chemical and/or process needs to be replaced). The methodology consists of comparison matrices (and the smaller comparison components) which allow replacement technology

  13. How Peru introduced a plan for comprehensive HIV prevention and care for transwomen.

    Science.gov (United States)

    Salazar, Ximena; Núnez-Curto, Arón; Villayzán, Jana; Castillo, Regina; Benites, Carlos; Caballero, Patricia; Cáceres, Carlos F

    2016-01-01

    As a group, transwomen in Peru have the highest prevalence of HIV (>20%) in the country, but they have little access to HIV prevention, testing and care services. Until recently, Peru's national HIV programme did not recognize transwomen and had remained essentially static for decades. This changed in December 2014, when the Ministry of Health expressed its commitment to improve programming for transwomen and to involve transwomen organizations by prioritizing the development of a "Targeted Strategy Plan of STIs/HIV/AIDS Prevention and Comprehensive Care for Transwomen." A policy dialogue between key stakeholders - Peru's Ministry of Health, academic scientists, civil society, transgender leaders and international agencies - created the conditions for a change in Peru's national HIV policy for transwomen. Supported by the effective engagement of all sectors, the Ministry of Health launched a plan to provide comprehensive HIV prevention and care for transwomen. The five-year plan includes new national guidelines for HIV prevention, care and support, and country-level investments in infrastructure and equipment. In addition to new biomedical strategies, the plan also incorporates several strategies to address structural factors that contribute to the vulnerability of transwomen. We identified three key factors that created the right conditions for this change in Peru's HIV policy. These factors include (1) the availability of solid evidence, based on scientific research; (2) ongoing efforts within the transwomen community to become better advocates of their own rights; and (3) a dialogue involving honest discussions between stakeholders about possibilities of changing the nation's HIV policy. The creation of Peru's national plan for HIV prevention and care for transwomen shows that long-term processes, focused on human rights for transwomen in Peru, can lead to organizational and public-policy change.

  14. High HIV incidence among young black men who have sex with men: constructing a retrospective cohort from a community health programme.

    Science.gov (United States)

    Friedman, M Reuel; Feliz, Nayck B; Netto, Jess; Adams, Brian J; Matthews, Derrick D; Stall, Ron D; Ho, Ken S; Krier, Sarah E; Silvestre, Anthony J

    2018-06-01

    We sought to calculate HIV incidence in a retrospective cohort of young (13-29 years old) black men who have sex with men (YBMSM) accessing repeated HIV-antibody testing in a mid-size city in the USA. We aggregated site-specific HIV-antibody testing results from the project's inception among YBMSM who received an initial negative result and accessed at least one additional HIV-antibody test. From these data, we assessed number of seroconversions and person-years and calculated HIV incidence using a mid-P exact test to estimate 95% CIs. Five seroconversions were documented over 42.3 person-years (the mean age at first onsite test: 19.7 years), resulting in an HIV incidence rate of 11.8% (95% CI 4.3% to 26.2%). The mean age at seroconversion was 20.4 (±3.0) years. Even in mid-size cities with low HIV prevalence rates in the general population, HIV incidence among YBMSM may be high. Community-based HIV-antibody testing organisations serving YBMSM should be encouraged and trained to track repeated HIV testing and calculate HIV incidence rates. Increased resources should be deployed to develop and encourage regular HIV testing in community health sites serving YBMSM. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. High-levels of acquired drug resistance in adult patients failing first-line antiretroviral therapy in a rural HIV treatment programme in KwaZulu-Natal, South Africa.

    Directory of Open Access Journals (Sweden)

    Justen Manasa

    Full Text Available To determine the frequency and patterns of acquired antiretroviral drug resistance in a rural primary health care programme in South Africa.Cross-sectional study nested within HIV treatment programme.Adult (≥ 18 years HIV-infected individuals initially treated with a first-line stavudine- or zidovudine-based antiretroviral therapy (ART regimen and with evidence of virological failure (one viral load >1000 copies/ml were enrolled from 17 rural primary health care clinics. Genotypic resistance testing was performed using the in-house SATuRN/Life Technologies system. Sequences were analysed and genotypic susceptibility scores (GSS for standard second-line regimens were calculated using the Stanford HIVDB 6.0.5 algorithms.A total of 222 adults were successfully genotyped for HIV drug resistance between December 2010 and March 2012. The most common regimens at time of genotype were stavudine, lamivudine and efavirenz (51%; and stavudine, lamivudine and nevirapine (24%. Median duration of ART was 42 months (interquartile range (IQR 32-53 and median duration of antiretroviral failure was 27 months (IQR 17-40. One hundred and ninety one (86% had at least one drug resistance mutation. For 34 individuals (15%, the GSS for the standard second-line regimen was <2, suggesting a significantly compromised regimen. In univariate analysis, individuals with a prior nucleoside reverse-transcriptase inhibitor (NRTI substitution were more likely to have a GSS <2 than those on the same NRTIs throughout (odds ratio (OR 5.70, 95% confidence interval (CI 2.60-12.49.There are high levels of drug resistance in adults with failure of first-line antiretroviral therapy in this rural primary health care programme. Standard second-line regimens could potentially have had reduced efficacy in about one in seven adults involved.

  16. A conceptual and analytical approach to comparative analysis of country case studies: HIV and TB control programmes and health systems integration

    DEFF Research Database (Denmark)

    Coker, Richard; Balen, Julie; Mounier-Jack, Sandra

    2010-01-01

    Attempts to comparatively analyse large-scale communicable disease control programmes have, for the most part, neglected the wider health system contexts within which the programmes lie. In addition, many evaluations of the integration of vertical disease control programmes into health systems ha...

  17. Accelerated HIV testing for PMTCT in maternity and labour wards is vital to capture mothers at a critical point in the programme at district level in Malawi.

    Science.gov (United States)

    Beltman, J J; Fitzgerald, M; Buhendwa, L; Moens, M; Massaquoi, M; Kazima, J; Alide, N; van Roosmalen, J

    2010-11-01

    Round the clock (24 hours×7 days) HIV testing is vital to maintain a high prevention of mother to child transmission (PMTCT) coverage for women delivering in district health facilities. PMTCT coverage increases when most of the pregnant women will have their HIV status tested. Therefore routine offering of HIV testing should be integrated and seen as a part of comprehensive antenatal care. For women who miss antenatal care and deliver in a health facility without having had their HIV status tested, the labour and maternity ward could still serve as other entry points.

  18. Grand Gulf-prioritization of regulatory requirements

    International Nuclear Information System (INIS)

    Meisner, M.J.

    1993-01-01

    As cost pressures mount, Grand Gulf nuclear station (GGNS) is relying increasingly on various prioritization approaches to implement, modify, eliminate, or defer regulatory requirements. Regulatory requirements can be prioritized through the use of three measures: (1) safety (or risk) significance; (2) cost; and (3) public policy (or political) significance. This paper summarizes GGNS' efforts to implement solutions to regulatory issues using these three prioritization schemes to preserve a balance between cost and safety benefit

  19. Patient retention, clinical outcomes and attrition-associated factors of HIV-infected patients enrolled in Zimbabwe's National Antiretroviral Therapy Programme, 2007-2010.

    Directory of Open Access Journals (Sweden)

    Tsitsi Mutasa-Apollo

    Full Text Available Since establishment of Zimbabwe's National Antiretroviral Therapy (ART Programme in 2004, ART provision has expanded from <5,000 to 369,431 adults by 2011. However, patient outcomes are unexplored.To determine improvement in health status, retention and factors associated with attrition among HIV-infected patients on ART.A retrospective review of abstracted patient records of adults ≥ 15 years who initiated ART from 2007 to 2009 was done. Frequencies and medians were calculated for rates of retention in care and changes in key health status outcomes at 6, 12, 24 and 36 months respectively. Cox proportional hazards models were used to determine factors associated with attrition.Of the 3,919 patients, 64% were female, 86% were either WHO clinical stage III or IV. Rates of patient retention at 6, 12, 24 and 36 months were 90.7%, 78.1%, 68.8% and 64.4%, respectively. After ART initiation, median weight gains at 6, 12, and 24 months were 3, 4.5, and 5.0 kgs whilst median CD4+ cell count gains at 6, 12 and 24 months were 122, 157 and 279 cells/µL respectively. Factors associated with an increased risk of attrition included male gender (AHR 1.2; 95% CI, 1.1-1.4, baseline WHO stage IV (AHR 1.7; 95% CI, 1.1-2.6, lower baseline body weight (AHR 2.0; 95% CI, 1.4-2. 8 and accessing care from higher level healthcare facilities (AHR 3.5; 95% 1.1-11.2.Our findings with regard to retention as well as clinical and immunological improvements following uptake of ART, are similar to what has been found in other settings. Factors influencing attrition also mirror those found in other parts of sub-Saharan Africa. These findings suggest the need to strengthen earlier diagnosis and treatment to further improve treatment outcomes. Whilst decentralisation improves ART coverage it should be coupled with strategies aimed at improving patient retention.

  20. Problem Prioritization in Usability Evaluation:

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2006-01-01

    Severity assessments enable prioritization of problems encountered during usability evaluations and thereby provide a device for guiding the utilization of design resources. However, designers' response to usability evaluations is also influenced by other factors, which may overshadow severity....... With the purpose of enhancing the impact of severity assessments, this study combines a field study of factors that influence the impact of evaluations with an experimental study of severity assessments made during usability inspections. The results show that even in a project receptive to input from evaluations...... their impact was highly dependent on conducting evaluations early. This accorded with an informal method that blended elements of usability evaluation and participatory design and could be extended with user-made severity assessments. The major cost associated with the evaluations was not finding but fixing...

  1. Achieving the HIV Prevention Impact of Voluntary Medical Male Circumcision: Lessons and Challenges for Managing Programs

    Science.gov (United States)

    Sgaier, Sema K.; Reed, Jason B.; Thomas, Anne; Njeuhmeli, Emmanuel

    2014-01-01

    Voluntary medical male circumcision (VMMC) is capable of reducing the risk of sexual transmission of HIV from females to males by approximately 60%. In 2007, the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommended making VMMC part of a comprehensive HIV prevention package in countries with a generalized HIV epidemic and low rates of male circumcision. Modeling studies undertaken in 2009–2011 estimated that circumcising 80% of adult males in 14 priority countries in Eastern and Southern Africa within five years, and sustaining coverage levels thereafter, could avert 3.4 million HIV infections within 15 years and save US$16.5 billion in treatment costs. In response, WHO/UNAIDS launched the Joint Strategic Action Framework for accelerating the scale-up of VMMC for HIV prevention in Southern and Eastern Africa, calling for 80% coverage of adult male circumcision by 2016. While VMMC programs have grown dramatically since inception, they appear unlikely to reach this goal. This review provides an overview of findings from the PLOS Collection “Voluntary Medical Male Circumcision for HIV Prevention: Improving Quality, Efficiency, Cost Effectiveness, and Demand for Services during an Accelerated Scale-up.” The use of devices for VMMC is also explored. We propose emphasizing management solutions to help VMMC programs in the priority countries achieve the desired impact of averting the greatest possible number of HIV infections. Our recommendations include advocating for prioritization and funding of VMMC, increasing strategic targeting to achieve the goal of reducing HIV incidence, focusing on programmatic efficiency, exploring the role of new technologies, rethinking demand creation, strengthening data use for decision-making, improving governments' program management capacity, strategizing for sustainability, and maintaining a flexible scale-up strategy informed by a strong monitoring, learning, and evaluation platform. PMID:24800840

  2. Achieving universal access and moving towards elimination of new HIV infections in Cambodia

    Science.gov (United States)

    Vun, Mean Chhi; Fujita, Masami; Rathavy, Tung; Eang, Mao Tang; Sopheap, Seng; Sovannarith, Samreth; Chhorvann, Chhea; Vanthy, Ly; Sopheap, Oum; Welle, Emily; Ferradini, Laurent; Sedtha, Chin; Bunna, Sok; Verbruggen, Robert

    2014-01-01

    systematic linkages across different services and communities, and achieved nearly universal coverage of HIV services nationwide. Still, the programme must continually (re)prioritize the most effective and efficient interventions, strengthen synergies between programmes, contribute to health system strengthening, and increase domestic funding so that the gains of the previous two decades are sustained, and the goal of zero new infections is reached. PMID:24950749

  3. Effects of PREPARE, a Multi-component, School-Based HIV and Intimate Partner Violence (IPV) Prevention Programme on Adolescent Sexual Risk Behaviour and IPV: Cluster Randomised Controlled Trial.

    Science.gov (United States)

    Mathews, Catherine; Eggers, Sander M; Townsend, Loraine; Aarø, Leif E; de Vries, Petrus J; Mason-Jones, Amanda J; De Koker, Petra; McClinton Appollis, Tracy; Mtshizana, Yolisa; Koech, Joy; Wubs, Annegreet; De Vries, Hein

    2016-09-01

    Young South Africans, especially women, are at high risk of HIV. We evaluated the effects of PREPARE, a multi-component, school-based HIV prevention intervention to delay sexual debut, increase condom use and decrease intimate partner violence (IPV) among young adolescents. We conducted a cluster RCT among Grade eights in 42 high schools. The intervention comprised education sessions, a school health service and a school sexual violence prevention programme. Participants completed questionnaires at baseline, 6 and 12 months. Regression was undertaken to provide ORs or coefficients adjusted for clustering. Of 6244 sampled adolescents, 55.3 % participated. At 12 months there were no differences between intervention and control arms in sexual risk behaviours. Participants in the intervention arm were less likely to report IPV victimisation (35.1 vs. 40.9 %; OR 0.77, 95 % CI 0.61-0.99; t(40) = 2.14) suggesting the intervention shaped intimate partnerships into safer ones, potentially lowering the risk for HIV.

  4. Modeling accidents for prioritizing prevention

    International Nuclear Information System (INIS)

    Hale, A.R.; Ale, B.J.M.; Goossens, L.H.J.; Heijer, T.; Bellamy, L.J; Mud, M.L.; Roelen, A.; Baksteen, H.; Post, J.; Papazoglou, I.A.; Bloemhoff, A.; Oh, J.I.H.

    2007-01-01

    The Workgroup Occupational Risk Model (WORM) project in the Netherlands is developing a comprehensive set of scenarios to cover the full range of occupational accidents. The objective is to support companies in their risk analysis and prioritization of prevention. This paper describes how the modeling has developed through projects in the chemical industry, to this one in general industry and how this is planned to develop further in the future to model risk prevention in air transport. The core modeling technique is based on the bowtie, with addition of more explicit modeling of the barriers needed for risk control, the tasks needed to ensure provision, use, monitoring and maintenance of the barriers, and the management resources and tasks required to ensure that these barrier life cycle tasks are carried out effectively. The modeling is moving from a static notion of barriers which can fail, to seeing risk control dynamically as (fallible) means for staying within a safe envelope. The paper shows how concepts develop slowly over a series of projects as a core team works continuously together. It concludes with some results of the WORM project and some indications of how the modeling is raising fundamental questions about the conceptualization of system safety, which need future resolution

  5. Disclosure of HIV Status in Rural Tanzania: Practices, Facilitators ...

    African Journals Online (AJOL)

    In Tanzania, HIV counselling and testing practices are now widely accepted as the cornerstone of HIV prevention programmes. Within HIV testing and counselling, emphasis is placed on the importance of individuals to disclose their HIV status. Despite increasing focus on disclosure of HIV status, relatively little is known ...

  6. Evaluating the impact of prioritization of antiretroviral pre-exposure prophylaxis (PrEP) in New York City

    Science.gov (United States)

    Kessler, Jason; Myers, Julie E.; Nucifora, Kimberly A.; Mensah, Nana; Toohey, Christopher; Khademi, Amin; Cutler, Blayne; Braithwaite, R. Scott

    2015-01-01

    Objective To compare the value and effectiveness of different prioritization strategies of pre-exposure prophylaxis (PrEP) in New York City (NYC). Design Mathematical modeling utilized as clinical trial is not feasible. Methods Using a model accounting for both sexual and parenteral transmission of HIV we compare different prioritization strategies (PPS) for PrEP to two scenarios—no PrEP and PrEP for all susceptible at-risk individuals. The PPS included PrEP for all MSM, only high-risk MSM, high-risk heterosexuals, and injection drug users, and all combinations of these four strategies. Outcomes included HIV infections averted, and incremental cost effectiveness (per-infection averted) ratios. Initial assumptions regarding PrEP included a 44% reduction in HIV transmission, 50% uptake in the prioritized population and an annual cost per person of $9,762. Sensitivity analyses on key parameters were conducted. Results Prioritization to all MSM results in a 19% reduction in new HIV infections. Compared to PrEP for all persons at-risk this PPS retains 79% of the preventative effect at 15% of the total cost. PrEP prioritized to only high-risk MSM results in a reduction in new HIV infections of 15%. This PPS retains 60% of the preventative effect at 6% of the total cost. There are diminishing returns when PrEP utilization is expanded beyond this group. Conclusions PrEP implementation is relatively cost-inefficient under our initial assumptions. Our results suggest that PrEP should first be promoted among MSM who are at particularly high-risk of HIV acquisition. Further expansion beyond this group may be cost-effective, but is unlikely to be cost-saving. PMID:25493594

  7. Use of prioritization in meeting regulatory requirements

    International Nuclear Information System (INIS)

    Bowling, M.L.; Sommers, D.A.; Girvin, L.M.

    1993-01-01

    The use of prioritization in the allocation of resources is certainly not a new idea. However, the degree to which prioritization must now be used is much greater than ever before. In the past, utilities generally allocated the necessary resources to meet all regulatory requirements and commitments. Prioritization was then applied to the remaining nonregulatory but required needs. This approach to resource allocation is no longer appropriate for the current and projected economic and operating environment. Key reasons for this conclusion are discussed in this paper by staff from Virginia Power

  8. 'Side effects' are 'central effects' that challenge retention on antiretroviral therapy in HIV treatment programmes in six sub-Saharan African countries

    DEFF Research Database (Denmark)

    Renju, Jenny; Moshabela, Mosa; McLean, Estelle

    2017-01-01

    PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories. Deductive and inductive analysis was guided by aspects of practice theory; retention in HIV care...... following ART initiation was the practice of interest. Results: PLHIV who were engaged in HIV care took ART every day, attended clinic appointments and ate as well as possible. For PLHIV, biomedical markers acted as reassurance for their positive treatment progression. However, many described ART side...... effects ranging from dizziness to conditions severe enough to prevent them from leaving home or caring for themselves or others. In all settings, the primary concern of HCW was ensuring patients achieved viral suppression, with management of side effects seen as a lower priority. Where PLHIV tolerated...

  9. Challenges to delivering quality care in a prevention of mother-to-child transmission of HIV programme in Soweto, South Africa

    Directory of Open Access Journals (Sweden)

    Coceka Nandipha Mnyani

    2013-06-01

    Full Text Available Objectives: There has been little focus on quality of care provided in prevention of mother-to-child transmission of HIV (PMTCT services in South Africa. We assessed quality of care in PMTCT services in Soweto, South Africa, focusing on knowledge and experiences of healthcare workers and HIV-infected pregnant women accessing the services. Methods: A cross-sectional survey was conducted between November and December 2009. A total of 201 HIV-infected pregnant women and 80 healthcare workers, from 10 antenatal clinics, were interviewed using standardised questionnaires. Results: The median gestational age at first antenatal visit was 20 weeks and 32 weeks at the time of the interview. The majority of the women, 71.5%, discovered that they were HIV-infected in the index pregnancy, and 87.9% disclosed their HIV status. Overall, 97.5% received counselling and 33.5% were members of a support group. Knowledge of antenatal and intrapartum PMTCT interventions was correct in 62.7% and 43.3% of the women, respectively. Support group membership and current use of antiretroviral prophylaxis did not impact on the quality of knowledge. Of the healthcare workers, 43.8% were professional nurses and 37.5% were lay counsellors. The majority, 80.0%, felt satisfied with their knowledge of PMTCT guidelines and 96.3% felt competent in managing HIV-infected pregnant women. Yet, there were important deficiencies in knowledge of the guidelines. Conclusion: In our study, knowledge of PMTCT interventions was low in both clients and healthcare workers. These findings point to a need to improve quality of care in PMTCT services, especially with increasingly complex PMTCT interventions recommended by international policies.

  10. Behavioral Correlates of Prioritizing Popularity in Adolescence

    NARCIS (Netherlands)

    van Den Broek, Nina; Deutz, Marike H F; Schoneveld, Elke A.; Burk, William J.; Cillessen, Antonius H N

    2016-01-01

    Little is known about individual differences in adolescents’ motivation to achieve and maintain popularity. This study examined the moderating effects of prioritizing popularity on the associations between popularity and adjustment outcomes in late adolescence. Participants were 314 Dutch

  11. "Not easy at all but I am trying": barriers and facilitators to physical activity in a South African cohort of people living with HIV participating in a home-based pedometer walking programme.

    Science.gov (United States)

    Roos, Ronel; Myezwa, Hellen; van Aswegen, Helena

    2015-01-01

    The promotion of physical activity is encouraged in people living with HIV and AIDS (PLWHA) as a means of promoting wellness and health. Adherence to programmes that promote exercise is often reduced, and home-based programmes are suggested to improve adherence. This study investigated the personal and environmental factors that cause barriers and facilitators of physical activity in a home-based pedometer walking programme as a means of highlighting adherence challenges. An observational study nested in a randomised controlled trial was conducted in a cohort of South African PLWHA on antiretroviral therapy over a six-month period. Descriptive analysis and qualitative content analysis of 42 participants who underwent physical activity modification assisted with data review. The mean age of the sample was 38.7 (±8.9) years, consisted mostly of women (n = 35; 83.3%) who were employed (n = 19; 45.2%) but earning very little (less than R500 per month) and often single or widowed (n = 23; 54.8%). Barriers to physical activity identified included physical complaints, e.g., low-energy levels; psychological complaints, e.g., stress levels; family responsibility, e.g., being primary caregivers; the physical environment, e.g., adverse weather conditions; social environment, e.g., domestic abuse and crime; and workplace, e.g., being in a sedentary job. Facilitators of physical activity included support and encouragement from friends and family, religious practices during worship and community environment, e.g., having access to parks and sport fields. The study is of benefit as it highlights personal and environmental factors that need to be considered when developing or implementing a home-based walking programme in PLWHA.

  12. The impact of exposure to mass media campaigns and social support on levels and trends of HIV-related stigma and discrimination in Nigeria: tools for enhancing effective HIV prevention programmes.

    Science.gov (United States)

    Fakolade, R; Adebayo, S B; Anyanti, J; Ankomah, A

    2010-05-01

    People living with HIV and AIDS (PLWHAs) often face stigma and discrimination, especially in developing countries. HIV-related stigma is expressed through social ostracism, personal rejection, direct and indirect discrimination, and denial from families and friends. Consequently, it is associated with reduced adoption of preventive and care behaviours, including condom use, seeking for HIV test and care-seeking behaviour subsequent to diagnosis. Ignorance about the epidemiology of the disease on modes of transmission and prevention aggravates HIV-related stigma in Nigeria. Behaviour change communication activities through mass media have been shown to be an effective approach in improving people's knowledge about the disease. This paper monitors trends in the level of accepting attitudes towards PLWHAs in Nigeria between 2003 and 2007. It also evaluates the impact of exposure to mass media and social support on the levels of accepting attitudes towards PLWHAs. A significant and positive trend was evident between 2003 and 2007 (pmedia communications on HIV and AIDS issues and social support were significantly related to the reduced stigma and discrimination against PLWHAs (p<0.0001).

  13. Perception of quality of care in HIV/AIDS programmes among patients in a tertiary health care facility in Anambra State.

    Science.gov (United States)

    Nwabueze, S A; Adogu, P O U; Ilika, A L; Asuzu, M C; Adinma, E D

    2011-01-01

    Continuous quality improvement is linked to the use of timely and useful feedback from clients in Human Immuno-deficiency Virus (HIV) care. HIV experts and care professionals agree that consumer involvement, such as patient satisfaction survey, is an essential part of HIV care and policy making today. The introduction ofAnti-Retroviral Treatment (ART) services in Nigeria has significantly impacted positively on the overall well being of People Living with HIV and Acquired Immune Deficiency Syndrome (PLWHA). However, there is little understanding of their satisfaction and perception of quality of care provided. Consequently, this study was carried out to assess patients' satisfaction with ambulatory HIV/AIDS care in a tertiary health facility in Anambra State. The study design is cross-sectional. A total of 150 patients from Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi were selected using systematic sampling technique from the daily AntiRetroviral (ARV) clinic register obtained from the medical records department of the centre. Data were collected using a structured interviewer-administered questionnaire and analyzed using SPSS version 13. The mean age of the respondents was 38.3 +/- 9.1. Majority (50.7%) of the patients was married, and most of them (74.7%) were semi-skilled workers. There was a statistically significant difference in the numbers of those who spent >240 naira for transportation to the clinic, compared to those who spent 30 minutes are significantly larger than the number that spent 750 naira than those who spend <750 naira on non-HIV related laboratory (20 versus 9) tests. PLWHAs in this facility were least satisfied with access to care, while they expressed greatest satisfaction with good patient care and quality of service by staff. The overall satisfaction score of the subjects was 4.04 +/- 0.33. HIV patients' overall satisfaction with the services provided to them was quite high. Therefore, there is need to sustain the current

  14. Priority setting in HIV/AIDS control in West Java Indonesia: an evaluation based on the accountability for reasonableness framework.

    Science.gov (United States)

    Tromp, Noor; Prawiranegara, Rozar; Subhan Riparev, Harris; Siregar, Adiatma; Sunjaya, Deni; Baltussen, Rob

    2015-04-01

    Indonesia has insufficient resources to adequately respond to the HIV/AIDS epidemic, and thus faces a great challenge in prioritizing interventions. In many countries, such priority setting processes are typically ad hoc and not transparent leading to unfair decisions. Here, we evaluated the priority setting process in HIV/AIDS control in West Java province against the four conditions of the accountability for reasonableness (A4R) framework: relevance, publicity, appeals and revision, and enforcement. We reviewed government documents and conducted semi-structured qualitative interviews based on the A4R framework with 22 participants of the 5-year HIV/AIDS strategy development for 2008-13 (West Java province) and 2007-11 (Bandung). We found that criteria for priority setting were used implicitly and that the strategies included a wide range of programmes. Many stakeholders were involved in the process but their contribution could be improved and particularly the public and people living with HIV/AIDS could be better engaged. The use of appeal and publicity mechanisms could be more transparent and formally stated. Public regulations are not yet installed to ensure fair priority setting. To increase fairness in HIV/AIDS priority setting, West Java should make improvements on all four conditions of the A4R framework. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  15. Test case prioritization using Cuscuta search

    Directory of Open Access Journals (Sweden)

    Mukesh Mann

    2014-12-01

    Full Text Available Most companies are under heavy time and resource constraints when it comes to testing a software system. Test prioritization technique(s allows the most useful tests to be executed first, exposing faults earlier in the testing process. Thus makes software testing more efficient and cost effective by covering maximum faults in minimum time. But test case prioritization is not an easy and straightforward process and it requires huge efforts and time. Number of approaches is available with their proclaimed advantages and limitations, but accessibility of any one of them is a subject dependent. In this paper, artificial Cuscuta search algorithm (CSA inspired by real Cuscuta parasitism is used to solve time constraint prioritization problem. We have applied CSA for prioritizing test cases in an order of maximum fault coverage with minimum test suite execution and compare its effectiveness with different prioritization ordering. Taking into account the experimental results, we conclude that (i The average percentage of faults detection (APFD is 82.5% using our proposed CSA ordering which is equal to the APFD of optimal and ant colony based ordering whereas No ordering, Random ordering and Reverse ordering has 76.25%, 75%, 68.75% of APFD respectively.

  16. Integrating Prevention of Mother to Child HIV Transmission competencies into the nursing curriculum: Methodological lessons from a university-based undergraduate programme.

    Science.gov (United States)

    Mbombo, Nomafrench; Bimerew, Million

    2012-11-14

    South Africa (SA) has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT). However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to render the service. In response to this, the School of Nursing at the University of the Western Cape has integrated PMTCT competencies into the undergraduate Bachelor of Nursing Science curriculum. In this paper, we described teaching and learning approaches used to integrate PMTCT competencies, including the skills laboratory methodology and case-based learning, as well as a portfolio of evidence assessment tool. A quantitative descriptive design was used to analyse data collected from students in regard to assessment of PMTCT competencies achieved. The study used the conceptual framework of Lenburg's competency outcomes and performance assessment model, which focuses on competency development and assessment in a clinical environment. HIV competencies, including PMTCT, should be integrated both theoretically and at service delivery into other nursing and midwifery competencies, including assessment strategies. Provincial policies in provision of antiretrovirals by nurses and midwives become barriers to successful implementation of PMTCT, resulting in limited learning opportunities for students to practice PMTCT competencies. Further research is required to assess an attribute, affect, which is another prong for competencies.

  17. Behavioral Correlates of Prioritizing Popularity in Adolescence.

    Science.gov (United States)

    van den Broek, Nina; Deutz, Marike H F; Schoneveld, Elke A; Burk, William J; Cillessen, Antonius H N

    2016-12-01

    Little is known about individual differences in adolescents' motivation to achieve and maintain popularity. This study examined the moderating effects of prioritizing popularity on the associations between popularity and adjustment outcomes in late adolescence. Participants were 314 Dutch eleventh-grade students (M age  = 16.83 years; 52 % male) who completed measures of popularity, prioritizing popularity, and prosocial, antisocial, and risk behaviors. It was hypothesized that associations between popularity and adjustment outcomes are stronger for adolescents who prioritize popularity. The results indicate that the combination of being popular and valuing popularity was strongly related to antisocial and risk behaviors, but not to prosocial behaviors. Adolescents' social status motivations thus play an important role in the association of popularity with antisocial and risk behaviors in late adolescence.

  18. Programme coverage, condom use and STI treatment among FSWs in a large-scale HIV prevention programme: results from cross-sectional surveys in 22 districts in southern India.

    Science.gov (United States)

    Ramakrishnan, Lakshmi; Gautam, Abhishek; Goswami, Prabuddhagopal; Kallam, Srinivasan; Adhikary, Rajatashuvra; Mainkar, Mandar K; Ramesh, Banadakoppa M; Morineau, Guy; George, Bitra; Paranjape, Ramesh S

    2010-02-01

    This paper evaluates Avahan programme's coverage of female sex workers (FSWs), focus on high-risk FSWs and intermediate outcomes. First round of cross-sectional survey data, Integrated Behavioral and Biological Assessments (IBBA), conducted in 22 districts, were aggregated into district categories: Solo, where Avahan was the sole service provider covering all FSWs and Major or Minor where Avahan was not the sole provider, but intended coverage was >50% or or=15 clients in the past week had a higher chance of being exposed to core services (AOR=1.56; 95% CI 1.03 to 2.35). Exposure to the three services in Solo Avahan districts was significantly associated with correct knowledge on condom use (AOR=1.36; 95% CI 1.05 to 1.78), consistent condom use with occasional clients (AOR=3.17; 95% CI 2.17 to 4.63) and regular clients (AOR=2.47; 95% CI 1.86 to 3.28) and STI treatment-seeking behaviour (AOR=3.00; 95% CI 1.94 to 4.65). Higher coverage of FSWs was achieved in districts where Avahan was the only intervention compared with districts having multiple and longstanding non-Avahan programmes. Exposure in Solo districts was associated with intermediate outcomes; this need to be further evaluated in comparison with non Avahan areas and substantiated through data from next IBBA.

  19. HIV and incarceration: prisons and detention.

    Science.gov (United States)

    Jürgens, Ralf; Nowak, Manfred; Day, Marcus

    2011-05-19

    The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release. We reviewed the evidence regarding HIV prevalence, risk behaviours and transmission in prisons. We also reviewed evidence of the effectiveness of interventions and approaches to reduce the risk behaviours and, consequently, HIV transmission in prisons. A large number of studies report high levels of risk behaviour in prisons, and HIV transmission has been documented. There is a large body of evidence from countries around the world of what prison systems can do to prevent HIV transmission. In particular, condom distribution programmes, accompanied by measures to prevent the occurrence of rape and other forms of non-consensual sex, needle and syringe programmes and opioid substitution therapies, have proven effective at reducing HIV risk behaviours in a wide range of prison environments without resulting in negative consequences for the health of prison staff or prisoners.The introduction of these programmes in prisons is therefore warranted as part of comprehensive programmes to address HIV in prisons, including HIV education, voluntary HIV testing and counselling, and provision of antiretroviral treatment for HIV-positive prisoners. In addition, however, action to reduce overcrowding and improve conditions in detention is urgently needed.

  20. A prioritization of generic safety issues

    International Nuclear Information System (INIS)

    Emrit, R.; Riggs, R.; Milstead, W.; Pittman, J.

    1991-07-01

    This report presents the priority rankings for generic safety issues and related to nuclear power plants. The purpose of these rankings is to assist in the timely and efficient allocation of NRC resources for the resolution of those safety issues that have a significant potential for reducing risk. The report focuses on the prioritization of generic safety issues. Issues primarily concerned with the licensing process or environmental protection and not directly related to safety have been excluded from prioritization. The prioritized issues include: TMI Action Plan items under development; previously proposed issues covered by Task Action Plans, except issues designated as Un-resolved Safety Issues (USIs) which had already been assigned high priority; and newly-proposed issues. Future supplements to this report will include the prioritization of additional issues. The safety priority rankings are High, Medium, Low, and Drop and have been assigned on the basis of risk significance estimates, the ratio of risk to costs and other impacts estimated to result if resolutions of the safety issues were implemented, and the consideration of uncertainties and other quantitative or qualitative factors. To the extent practical, estimates are quantitative. 1310 refs

  1. Public health lessons from a pilot programme to reduce mother-to ...

    African Journals Online (AJOL)

    Public health lessons from a pilot programme to reduce mother-to-child transmission of HIV-1 in Khayelitsha. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... took blood for HIV enzyme-linked imrnunosorbent assay (EUSA) testing.

  2. Evaluation of selected aspects of the Nutrition Therapeutic Programme offered to HIV-positive women of child-bearing age in Western Cape Province, South Africa

    Directory of Open Access Journals (Sweden)

    Tine T. Hansen

    2015-04-01

    Objective: To evaluate implementation of the NTP at PHCs that provide antiretroviral therapy. Methods: A cross-sectional, descriptive study was conducted at 17 PHCs located within 3 districts of Western Cape Province. Two target groups were chosen: 32 staff members working at the sites and 21 women of child-bearing age enrolled in the NTP. Questionnaires were used to obtain data. Results: Only 2 women (10% lived in food-secure households; the rest were either at risk of hunger (29% or classified as hungry (61%. Most of the women knew they had to take the supplements to improve their nutritional status, but the majority only recalled receiving basic nutritional advice, and the information was mainly given verbally. Ten of the women had shared their supplements with others, mostly with their children. The study identified lack of clearly defined NTP responsibilities at the PHCs, causing confusion amongst the staff. Although many staff members expressed problems with the NTP, only 38% of them reported having routine evaluations regarding the programme. Conclusion: Several aspects compromised the effectiveness of the NTP, including socio- economic factors leading to clients’ non-compliance. The strategic organisation and implementation of the NTP varied between different PHCs offering antiretroviral therapy, and staff experienced difficulties with the logistics of the programme.

  3. Air pollution and vulnerability: solving the puzzle of prioritization

    CSIR Research Space (South Africa)

    Wright, CY

    2011-01-01

    Full Text Available conditions exacerbates the problem. Air quality management plans identify prioritized strategies for improved air quality independent of consideration of vulnerability. A population exposure and vulnerability risk prioritization framework comprising five...

  4. Ecoregion prioritization suggests an armoury not a silver bullet for conservation planning.

    Directory of Open Access Journals (Sweden)

    Stephan M Funk

    Full Text Available In the face of accelerating species extinctions, map-based prioritization systems are increasingly useful to decide where to pursue conservation action most effectively. However, a number of seemingly inconsistent schemes have emerged, mostly focussing on endemism. Here we use global vertebrate distributions in terrestrial ecoregions to evaluate how continuous and categorical ranking schemes target and accumulate endangered taxa within the IUCN Red List, Alliance for Zero Extinction (AZE, and EDGE of Existence programme. We employed total, endemic and threatened species richness and an estimator for richness-adjusted endemism as metrics in continuous prioritization, and WWF's Global200 and Conservation International's (CI Hotspots in categorical prioritization. Our results demonstrate that all metrics target endangerment more efficiently than by chance, but each selects unique sets of top-ranking ecoregions, which overlap only partially, and include different sets of threatened species. Using the top 100 ecoregions as defined by continuous prioritization metrics, we develop an inclusive map for global vertebrate conservation that incorporates important areas for endemism, richness, and threat. Finally, we assess human footprint and protection levels within these areas to reveal that endemism sites are more impacted but have more protection, in contrast to high richness and threat ones. Given such contrasts, major efforts to protect global biodiversity must involve complementary conservation approaches in areas of unique species as well as those with highest diversity and threat.

  5. Pre- and post-intervention assessment of a PMTCT-programme ...

    African Journals Online (AJOL)

    PMTCT) services following implementation of programme-strengthening activities in a ... Keywords: antenatal care, health service delivery, HIV/AIDS, maternal health services, postnatal care, programme evaluation, quantitative research, women

  6. PRIORITIZING ECONOMIC GROWTH: ENHANCING MACROECONOMIC POLICY CHOICE

    OpenAIRE

    Colin I. BRADFORD, Jr.

    2005-01-01

    This paper spells out a logic for increasing macroeconomic policy space in order to prioritize the goals of growth, employment creation and poverty reduction. First, there is the need to create additional policy instruments so that a greater number of policy goals can be addressed. Frequently, real economy goals get partly crowded out by financial objectives because there are too few instruments for too many goals. Second, the calibrated use of policy tools by degrees of commitment, deploymen...

  7. Core indicators evaluation of effectiveness of HIV-AIDS preventive-control programmes carried out by nongovernmental organizations. A mixed method study

    Directory of Open Access Journals (Sweden)

    Mansilla Rosa

    2011-07-01

    Full Text Available Abstract Background The number of nongovernmental organizations working on AIDS has grown. There is great diversity in the type of activities and population groups that have been targeted. The purposes of this study are: to describe and analyze the objectives and HIV-AIDS preventive activities that are carried out by the AIDS-NGOs that work with AIDS in Catalonia and that receive subsidies from the Department of Health; and to develop a comprehensive proposal for measurable and agreed upon core quality evaluation indicators to monitor and assess those objectives and activities that can have an impact on the fight against inequalities and stigmatization, and incorporate the perspectives of the service providers and users. Methods A mixed method study has been carried out with professionals from the 36 NGOs that work with HIV/AIDS in Catalonia, as well as their users. This study achieved the completeness model using the following phases: 1. A systematic review of AIDS-NGOs annual reports and preparation of a catalogue of activities grouped by objectives, level of prevention and AIDS-NGOs target population; 2. A transversal study through an ad-hoc questionnaire administered to the AIDS-NGOs representatives; 3. A qualitative study with a phenomenological approach through focus groups, individual interviews and observations; 4. Consensus meetings between AIDS-NGOs professionals and the research team using Haddon matrices in order to establish a proposal of evaluation indicators. Results The information was classified according to level of prevention and level of intervention. A total of 248 objectives and 258 prevention activities were identified. 1564 evaluation indicators, addressed to 7 target population groups, were produced. Thirty core activities were selected. The evaluation indicators proposed for these activities were: 76 indicators for 15 primary prevention activities, 43 for 5 secondary prevention activities and 68 for 10 tertiary

  8. Core indicators evaluation of effectiveness of HIV-AIDS preventive-control programmes carried out by nongovernmental organizations. A mixed method study.

    Science.gov (United States)

    Berenguera, Anna; Pujol-Ribera, Enriqueta; Violan, Concepció; Romaguera, Amparo; Mansilla, Rosa; Giménez, Albert; Ascaso, Carlos; Almeda, Jesús

    2011-07-28

    The number of nongovernmental organizations working on AIDS has grown. There is great diversity in the type of activities and population groups that have been targeted. The purposes of this study are: to describe and analyze the objectives and HIV-AIDS preventive activities that are carried out by the AIDS-NGOs that work with AIDS in Catalonia and that receive subsidies from the Department of Health; and to develop a comprehensive proposal for measurable and agreed upon core quality evaluation indicators to monitor and assess those objectives and activities that can have an impact on the fight against inequalities and stigmatization, and incorporate the perspectives of the service providers and users. A mixed method study has been carried out with professionals from the 36 NGOs that work with HIV/AIDS in Catalonia, as well as their users. This study achieved the completeness model using the following phases:1. A systematic review of AIDS-NGOs annual reports and preparation of a catalogue of activities grouped by objectives, level of prevention and AIDS-NGOs target population; 2. A transversal study through an ad-hoc questionnaire administered to the AIDS-NGOs representatives; 3. A qualitative study with a phenomenological approach through focus groups, individual interviews and observations; 4. Consensus meetings between AIDS-NGOs professionals and the research team using Haddon matrices in order to establish a proposal of evaluation indicators. The information was classified according to level of prevention and level of intervention. A total of 248 objectives and 258 prevention activities were identified. 1564 evaluation indicators, addressed to 7 target population groups, were produced. Thirty core activities were selected. The evaluation indicators proposed for these activities were: 76 indicators for 15 primary prevention activities, 43 for 5 secondary prevention activities and 68 for 10 tertiary prevention activities. The results could help to homogeneously

  9. Improved Prioritization Criteria for Road Infrastructure Projects

    Directory of Open Access Journals (Sweden)

    Ionescu Heroiu Marcel

    2016-12-01

    Full Text Available This report’s main aim is to propose a methodology for assessing state-budget-funded projects based on a rigorous selection model, including clear and effective prioritization criteria. This report first argues that project prioritization and selection should be optimized against four dimensions: absorption, impact, legitimacy, and capacity. Second, it provides a diagnostic of the National Program for Local Development (PNDL, managed by the Ministry of Regional Development and Public Administration (MRDPA, as the most significant source of state-budget funding for local infrastructure projects. The PNDL’s current design and implementation leaves room for improvement, as reflected by the lack of strategic direction in allocating funds and the continued rise in the number of projects that get started without a feasible timeline for their completion. Further, this report makes recommendations for improvement of project evaluation and selection procedures for local infrastructure development projects, with a special focus on prioritization criteria and viable funding sources for each type of investment. The practical purpose is to enhance the efficiency and effectiveness of proposed investments, maximizing impact in the context of inherently limited available financial resources. A complementary focus is on opportunities for harmonizing and better coordinating investments across various sources of funding, in the context of nearly EUR 40 billion available to Romania from the EU for the 2014-2020 programming period.

  10. ‘Low-hanging fruit’: Counting and accounting for children in PEPFAR-funded HIV/AIDS programmes in South Africa

    Science.gov (United States)

    Reynolds, Lindsey J.

    2014-01-01

    The article traces the social life of a policy that aimed to define and circumscribe the ambiguous and contested category of the ‘orphaned and vulnerable children’ (OVC) in South Africa at the height of the ‘emergency response’ to HIV/AIDS. Drawing on several months of institutional ethnographic research conducted over the course of five years with South African organisations receiving funding from the US President’s Emergency Plan for AIDS Relief to provide services to ‘OVC’, the project interrogates the influence of governmental forms of counting and accounting on health policy and practice in South Africa. Focusing on the experiences of one organisation, the article describes a process of policy ‘translation’ typified by a series of disconnects between the intentions of a policy and the exigencies of implementation, structured by the ambiguous and flexible nature of the category of the ‘orphaned and vulnerable child’. In this context, the article argues, the uncertainty produced by the implementation of the guidelines was not simply an artifact of a poorly designed policy, but rather signals an underlying epistemological tension in the practice of ‘global health’, in which quantitative metrics designed for monitoring and evaluation are often incapable of approximating the complexities of everyday life. PMID:24498970

  11. Crispv programme

    International Nuclear Information System (INIS)

    Marinkovicj, N.

    CRISPV (Criticality and Spectrum code) is a multigroup neutron spectrum code for homogeneous reactor cores and is actually a somewhat modified version of the original CRISP programme. It is a combination of DATAPREP-II and BIGG-II programmes. It is assumed that the reactor cell is a cylindrical fuel rod in the light or heavy water moderator. DATEPREP-II CODE forms the multigroup data for homogeneous reactor and prepares the input parameters for the BIGG-II code. It has its own nuclear data library on a separate tape in binary mode. BIGG-II code is a multigroup neutron spectrum and criticality code for a homogenized medium. It has as well its own separate data library. In the CRISPV programme the overlay structure enables automatic handling of data calculated in the DATAPREP-II programme and needed in the BIGG-II core. Both programmes are written in FORTRAN for CDC 3600. Using the programme is very efficient and simple

  12. Multi-Stakeholder Case Prioritization in Digital Investigations

    Directory of Open Access Journals (Sweden)

    Joshua I. James

    2014-09-01

    Full Text Available This work examines the problem of case prioritization in digital investigations for better utilization of limited criminal investigation resources. Current methods of case prioritization, as well as observed prioritization methods used in digital forensic investigation laboratories are examined. After, a multi-stakeholder approach to case prioritization is given that may help reduce reputational risk to digital forensic laboratories while improving resource allocation. A survey is given that shows differing opinions of investigation priority between Law Enforcement and the public that is used in the development of a prioritization model. Finally, an example case is given to demonstrate the practicality of the proposed method.

  13. Text mining in cancer gene and pathway prioritization.

    Science.gov (United States)

    Luo, Yuan; Riedlinger, Gregory; Szolovits, Peter

    2014-01-01

    Prioritization of cancer implicated genes has received growing attention as an effective way to reduce wet lab cost by computational analysis that ranks candidate genes according to the likelihood that experimental verifications will succeed. A multitude of gene prioritization tools have been developed, each integrating different data sources covering gene sequences, differential expressions, function annotations, gene regulations, protein domains, protein interactions, and pathways. This review places existing gene prioritization tools against the backdrop of an integrative Omic hierarchy view toward cancer and focuses on the analysis of their text mining components. We explain the relatively slow progress of text mining in gene prioritization, identify several challenges to current text mining methods, and highlight a few directions where more effective text mining algorithms may improve the overall prioritization task and where prioritizing the pathways may be more desirable than prioritizing only genes.

  14. Nutrition Status of HIV+ Children in Botswana

    Science.gov (United States)

    Nnyepi, Maria; Bennink, Maurice R.; Jackson-Malete, Jose; Venkatesh, Sumathi; Malete, Leapetswe; Mokgatlhe, Lucky; Lyoka, Philemon; Anabwani, Gabriel M.; Makhanda, Jerry; Weatherspoon, Lorraine J.

    2015-01-01

    Purpose: Identifying and addressing poor nutritional status in school-aged children is often not prioritized relative to HIV/AIDS treatment. The purpose of this paper is to elucidate the benefits of integrating nutrition (assessment and culturally acceptable food supplement intervention) in the treatment strategy for this target group.…

  15. [HIV Stigma and Spiritual Care in People Living With HIV].

    Science.gov (United States)

    Yu, Chia-Hui; Chiu, Yi-Chi; Cheng, Su-Fen; Ko, Nai-Ying

    2018-06-01

    HIV infection has been a manageable and chronic illness in Taiwan since the highly active antiretroviral therapy was introduced in 1997. HIV infection is a stigmatized disease due to its perceived association with risky behaviors. HIV often carries a negative image, and people living with HIV(PLWH) face discrimination on multiple fronts. Internalized HIV stigma impacts the spiritual health of people living with HIV in terms of increased levels of shame, self-blame, fear of disclosing HIV status, and isolation and decreased value and connections with God, others, the environment, and the self. Nursing professionals provide holistic care for all people living with HIV and value their lives in order to achieve the harmony of body, mind, and spirit. This article describes the stigma that is currently associated with HIV and how stigma-related discrimination affects the spiritual health of PLWH and then proposes how to reduce discrimination and stigma in order to improve the spiritual health of PLWH through appropriate spiritual care. Reducing HIV stigma and promoting spiritual well-being will enable Taiwan to achieve the 'Three Zeros' of zero discrimination, zero infection, and zero death advocated by the Joint United Nations Programme on HIV/AIDS for ending the AIDS epidemic in 2030.

  16. Scuba: scalable kernel-based gene prioritization.

    Science.gov (United States)

    Zampieri, Guido; Tran, Dinh Van; Donini, Michele; Navarin, Nicolò; Aiolli, Fabio; Sperduti, Alessandro; Valle, Giorgio

    2018-01-25

    The uncovering of genes linked to human diseases is a pressing challenge in molecular biology and precision medicine. This task is often hindered by the large number of candidate genes and by the heterogeneity of the available information. Computational methods for the prioritization of candidate genes can help to cope with these problems. In particular, kernel-based methods are a powerful resource for the integration of heterogeneous biological knowledge, however, their practical implementation is often precluded by their limited scalability. We propose Scuba, a scalable kernel-based method for gene prioritization. It implements a novel multiple kernel learning approach, based on a semi-supervised perspective and on the optimization of the margin distribution. Scuba is optimized to cope with strongly unbalanced settings where known disease genes are few and large scale predictions are required. Importantly, it is able to efficiently deal both with a large amount of candidate genes and with an arbitrary number of data sources. As a direct consequence of scalability, Scuba integrates also a new efficient strategy to select optimal kernel parameters for each data source. We performed cross-validation experiments and simulated a realistic usage setting, showing that Scuba outperforms a wide range of state-of-the-art methods. Scuba achieves state-of-the-art performance and has enhanced scalability compared to existing kernel-based approaches for genomic data. This method can be useful to prioritize candidate genes, particularly when their number is large or when input data is highly heterogeneous. The code is freely available at https://github.com/gzampieri/Scuba .

  17. HIV sero-conversion during late pregnancy – when to retest | Kalk ...

    African Journals Online (AJOL)

    The South African National Prevention of Mother-to-Child Transmission of HIV programme has resulted in significant reductions in vertical transmission, but new infant HIV infections continue to occur. We present two cases of HIV seroconversion during late pregnancy, demonstrating the limitations of the current programme.

  18. Appreciative inquiry into lifeskills-based HIV/AIDS education in ...

    African Journals Online (AJOL)

    With a steady rise in the prevalence of HIV and AIDS throughout the world it has become vital for programme implementers at all levels to ensure that all HIV intervention programmes are effectively put into practice. The present research used qualitative and quantitative data to evaluate the lifeskills-based HIV/AIDS ...

  19. Association between health systems performance and treatment outcomes in patients co-infected with MDR-TB and HIV in KwaZulu-Natal, South Africa: implications for TB programmes.

    Directory of Open Access Journals (Sweden)

    Marian Loveday

    Full Text Available To improve the treatment of MDR-TB and HIV co-infected patients, we investigated the relationship between health system performance and patient treatment outcomes at 4 decentralised MDR-TB sites.In this mixed methods case study which included prospective comparative data, we measured health system performance using a framework of domains comprising key health service components. Using Pearson Product Moment Correlation coefficients we quantified the direction and magnitude of the association between health system performance and MDR-TB treatment outcomes. Qualitative data from participant observation and interviews analysed using systematic text condensation (STC complemented our quantitative findings.We found significant differences in treatment outcomes across the sites with successful outcomes varying from 72% at Site 1 to 52% at Site 4 (p<0.01. Health systems performance scores also varied considerably across the sites. Our findings suggest there is a correlation between treatment outcomes and overall health system performance which is significant (r = 0.99, p<0.01, with Site 1 having the highest number of successful treatment outcomes and the highest health system performance. Although the 'integration' domain, which measured integration of MDR-TB services into existing services appeared to have the strongest association with successful treatment outcomes (r = 0.99, p<0.01, qualitative data indicated that the 'context' domain influenced the other domains.We suggest that there is an association between treatment outcomes and health system performance. The chance of treatment success is greater if decentralised MDR-TB services are integrated into existing services. To optimise successful treatment outcomes, regular monitoring and support are needed at a district, facility and individual level to ensure the local context is supportive of new programmes and implementation is according to guidelines.

  20. From Prioritizing Objects to Prioritizing Cues: A Developmental Shift for Cognitive Control

    Science.gov (United States)

    Chevalier, Nicolas; Dauvier, Bruno; Blaye, Agnès

    2018-01-01

    Emerging cognitive control supports increasingly adaptive behaviors and predicts life success, while low cognitive control is a major risk factor during childhood. It is therefore essential to understand how it develops. The present study provides evidence for an age-related shift in the type of information that children prioritize in their…

  1. Semantic prioritization of novel causative genomic variants

    KAUST Repository

    Boudellioua, Imene

    2017-04-17

    Discriminating the causative disease variant(s) for individuals with inherited or de novo mutations presents one of the main challenges faced by the clinical genetics community today. Computational approaches for variant prioritization include machine learning methods utilizing a large number of features, including molecular information, interaction networks, or phenotypes. Here, we demonstrate the PhenomeNET Variant Predictor (PVP) system that exploits semantic technologies and automated reasoning over genotype-phenotype relations to filter and prioritize variants in whole exome and whole genome sequencing datasets. We demonstrate the performance of PVP in identifying causative variants on a large number of synthetic whole exome and whole genome sequences, covering a wide range of diseases and syndromes. In a retrospective study, we further illustrate the application of PVP for the interpretation of whole exome sequencing data in patients suffering from congenital hypothyroidism. We find that PVP accurately identifies causative variants in whole exome and whole genome sequencing datasets and provides a powerful resource for the discovery of causal variants.

  2. Semantic prioritization of novel causative genomic variants

    KAUST Repository

    Boudellioua, Imene; Mohamad Razali, Rozaimi; Kulmanov, Maxat; Hashish, Yasmeen; Bajic, Vladimir B.; Goncalves-Serra, Eva; Schoenmakers, Nadia; Gkoutos, Georgios V.; Schofield, Paul N.; Hoehndorf, Robert

    2017-01-01

    Discriminating the causative disease variant(s) for individuals with inherited or de novo mutations presents one of the main challenges faced by the clinical genetics community today. Computational approaches for variant prioritization include machine learning methods utilizing a large number of features, including molecular information, interaction networks, or phenotypes. Here, we demonstrate the PhenomeNET Variant Predictor (PVP) system that exploits semantic technologies and automated reasoning over genotype-phenotype relations to filter and prioritize variants in whole exome and whole genome sequencing datasets. We demonstrate the performance of PVP in identifying causative variants on a large number of synthetic whole exome and whole genome sequences, covering a wide range of diseases and syndromes. In a retrospective study, we further illustrate the application of PVP for the interpretation of whole exome sequencing data in patients suffering from congenital hypothyroidism. We find that PVP accurately identifies causative variants in whole exome and whole genome sequencing datasets and provides a powerful resource for the discovery of causal variants.

  3. Prioritization of environmental cleanup problems at Hanford

    International Nuclear Information System (INIS)

    Fassbender, L.L.

    1994-01-01

    New technologies and scientific research are needed to clean up the Hanford Site. However, there is insufficient funding to develop every technology that is identified or to undertake every scientific research project that is proposed. Thus, the Department of Energy (DOE) must focus its resources on science and technology (S ampersand T) that will have the most significant impacts on the overall cleanup effort. Hanford has recognized the importance of identifying and prioritizing its most critical problems and the most promising solutions to them. Hanford cleanup will require numerous decisions about technology development and implementation, which will be complicated because there are substantial uncertainties about the risks and the costs of new technologies. Further, the choice of a specific technology for a specific application must be evaluated with respect to multiple (and often conflicting) objectives (e.g., risk reduction, increasing effectiveness, cost reduction, increasing public acceptability, regulatory compliance). This paper provides an overview of the decision analysis methodology that was used to prioritize S ampersand T needs for Hanford cleanup

  4. Adjoint de programme régional (h/f) | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    L'adjoint de programme doit établir les priorités parmi les multiples ... sur un système de contrôle, en établissant l'ordre prioritaire afin de respecter les ... Au besoin, aider les agents de gestion de programme à entretenir et à mettre à jour les ...

  5. Monitoring programme

    International Nuclear Information System (INIS)

    1994-06-01

    Her Majesty's Inspectorate of Pollution's 1992 report on its programme of monitoring radioactive substances is presented. Site operators' returns are verified and the report provides independent data on the environmental impact of authorized disposal of radioactive wastes. Radiation doses which may have been received by members of the public, fall well below the International Commission for Radiological Protection's (ICRP) recommended annual doses. (UK)

  6. TUBERCULOSIS/HIV CO-INFECTION

    African Journals Online (AJOL)

    cases of HIV infection and 1.8 million AIDS related deaths occur ... largely by specialised hospitals. The burden of ... matters internationally and that control programmes would be .... cost; field level evaluation showed promising results and this ...

  7. A PERSPECTIVE ON PRIORITIZATION IN PROJECT PORTFOLIO ENVIRONMENT

    OpenAIRE

    Eberhardt, Henrik; Lindblom, David

    2011-01-01

    The overbridging aspect of this interpretative master thesis is the implementation of a project prioritizing strategy. The concept is subdivided into three processes and entities, which could be seen as tools; project management office(PMO), project evaluation and project selection, which in turn are discussed separately. The thesis investigates how the tools impact the prioritizing strategy and why a company must follow a certain prioritizing strategy. The primary focus has been an IS/IT dep...

  8. Dynamic characteristic analysis of mother to child transmission of HIV in India

    Directory of Open Access Journals (Sweden)

    A. S. Kadi

    2014-01-01

    Full Text Available In this study, a mathematical model of HIV/AIDS mother to child transmission to analyze the effectiveness of prevention of HIV mother to child transmission programmes has been presented. The result reveals that prevention of HIV mother to child transmission programmes focusing only on biological transmission cannot control the increase of the HIV mother to child transmission in India. Hence, to control the HIV MTCT epidemic in India, in spite of strengthening the PMTCT programmes to reduce transmission rates, effective measures should be taken to prevent HIV infection in women of reproductive ages. Since the overall HIV MTCT epidemic is dependent on the HIV incidence in women of reproductive age group, the integration of pediatric HIV model with a detailed model of adult HIV would be investigated in future studies in order to model these dynamics more accurately.

  9. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

    OpenAIRE

    Shah, Ira; Lala, Mamatha; Damania, Kaizad

    2017-01-01

    Aim: Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother–to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. Materials and Methods: All pregnant women referr...

  10. A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis.

    Science.gov (United States)

    Nyblade, Laura; Jain, Aparna; Benkirane, Manal; Li, Li; Lohiniva, Anna-Leena; McLean, Roger; Turan, Janet M; Varas-Díaz, Nelson; Cintrón-Bou, Francheska; Guan, Jihui; Kwena, Zachary; Thomas, Wendell

    2013-11-13

    Within healthcare settings, HIV-related stigma is a recognized barrier to access of HIV prevention and treatment services and yet, few efforts have been made to scale-up stigma reduction programs in service delivery. This is in part due to the lack of a brief, simple, standardized tool for measuring stigma among all levels of health facility staff that works across diverse HIV prevalence, language and healthcare settings. In response, an international consortium led by the Health Policy Project, has developed and field tested a stigma measurement tool for use with health facility staff. Experts participated in a content-development workshop to review an item pool of existing measures, identify gaps and prioritize questions. The resulting questionnaire was field tested in six diverse sites (China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis). Respondents included clinical and non-clinical staff. Questionnaires were self- or interviewer-administered. Analysis of item performance across sites examined both psychometric properties and contextual issues. The key outcome of the process was a substantially reduced questionnaire. Eighteen core questions measure three programmatically actionable drivers of stigma within health facilities (worry about HIV transmission, attitudes towards people living with HIV (PLHIV), and health facility environment, including policies), and enacted stigma. The questionnaire also includes one short scale for attitudes towards PLHIV (5-item scale, α=0.78). Stigma-reduction programmes in healthcare facilities are urgently needed to improve the quality of care provided, uphold the human right to healthcare, increase access to health services, and maximize investments in HIV prevention and treatment. This brief, standardized tool will facilitate inclusion of stigma measurement in research studies and in routine facility data collection, allowing for the monitoring of stigma within healthcare facilities and evaluation of

  11. affordable management of hiv infection in the private sector

    African Journals Online (AJOL)

    Management (Pty) Ltd (PBM) has developed a comprehensive programme ('Aid for AIDS') to allow for reimburseme.ilt of all aspects of treatment of HIV/ AIDS. Its aim is to facilitate clinical and financial management of HIV infection and to reimburse the most ... pharmacists and hospitals deal directly with the unit, HIV- positive ...

  12. Courting success in HIV/AIDS prevention: the challenges of ...

    African Journals Online (AJOL)

    This article presents findings from a study of HIV/AIDS programmes for urban sex workers in Dakar, Senegal. The objective of the research was to assess HIV prevention and treatment efforts to date, and to identify challenges that must be overcome in the long term to reduce the spread of HIV in Senegal. The research team ...

  13. Treating 'AIDS blindness': A critical pedagogical approach to HIV ...

    African Journals Online (AJOL)

    HIV and AIDS affect all South Africans, irrespective of gender, race, age and economic status. Teachers should therefore be able to meaningfully integrate HIV content into the school curriculum. However, pre-service teacher education programmes still do not pay adequate attention to HIV education, particularly in ...

  14. Developing and implementing global gender policy to reduce HIV ...

    African Journals Online (AJOL)

    In March 2010 the Joint United Nations Programme on HIV/AIDS (UNAIDS) launched the Agenda for accelerated country level action on women, girls, gender equality and HIV (the Agenda), an operational plan on how to integrate women, girls and gender equality into the HIV response. This paper explores the perspectives ...

  15. Prioritizing conservation investments for mammal species globally

    Science.gov (United States)

    Wilson, Kerrie A.; Evans, Megan C.; Di Marco, Moreno; Green, David C.; Boitani, Luigi; Possingham, Hugh P.; Chiozza, Federica; Rondinini, Carlo

    2011-01-01

    We need to set priorities for conservation because we cannot do everything, everywhere, at the same time. We determined priority areas for investment in threat abatement actions, in both a cost-effective and spatially and temporally explicit way, for the threatened mammals of the world. Our analysis presents the first fine-resolution prioritization analysis for mammals at a global scale that accounts for the risk of habitat loss, the actions required to abate this risk, the costs of these actions and the likelihood of investment success. We evaluated the likelihood of success of investments using information on the past frequency and duration of legislative effectiveness at a country scale. The establishment of new protected areas was the action receiving the greatest investment, while restoration was never chosen. The resolution of the analysis and the incorporation of likelihood of success made little difference to this result, but affected the spatial location of these investments. PMID:21844046

  16. Data Partitioning Technique for Improved Video Prioritization

    Directory of Open Access Journals (Sweden)

    Ismail Amin Ali

    2017-07-01

    Full Text Available A compressed video bitstream can be partitioned according to the coding priority of the data, allowing prioritized wireless communication or selective dropping in a congested channel. Known as data partitioning in the H.264/Advanced Video Coding (AVC codec, this paper introduces a further sub-partition of one of the H.264/AVC codec’s three data-partitions. Results show a 5 dB improvement in Peak Signal-to-Noise Ratio (PSNR through this innovation. In particular, the data partition containing intra-coded residuals is sub-divided into data from: those macroblocks (MBs naturally intra-coded, and those MBs forcibly inserted for non-periodic intra-refresh. Interactive user-to-user video streaming can benefit, as then HTTP adaptive streaming is inappropriate and the High Efficiency Video Coding (HEVC codec is too energy demanding.

  17. A prioritization methodology to strategic planning process

    International Nuclear Information System (INIS)

    Rondinelli Junior, Francisco; Cherif, Hadj Slimane

    2009-01-01

    In the process of formulation of a Strategic Plan, there is always a step that deals with choices among different options and strategies. To do that a prioritization methodology has to be applied in order to achieve the higher needs identified along the analysis and evaluation of problems. To assign priorities within a set of needs/problems of a strategic nature and identified within various areas of activity or different sectors, it is proposed a methodology that envisage the use of specific attributes for which a graded scale of values is established for each need/problem, which, at the end of the process, allows a quantitative comparison among them. The methodology presented in this paper was developed following an approach that has been used in many areas over the last 20 years by various public and private institutions, and also by international organizations involved in promotion and development work. (author)

  18. Krsko periodic safety review project prioritization process

    International Nuclear Information System (INIS)

    Basic, I.; Vrbanic, I.; Spiler, J.; Lambright, J.

    2004-01-01

    Definition of a Krsko Periodic Safety Review (PSR) project is a comprehensive safety review of a plant after last ten years of operation. The objective is a verification by means of a comprehensive review using current methods that Krsko NPP remains safety when judged against current safety objectives and practices and that adequate arrangements are in place to maintain plant safety. This objective encompasses the three main criteria or goals: confirmation that the plant is as safe as originally intended, determination if there are any structures, systems or components that could limit the life of the plant in the foreseeable future, and comparison the plant against modern safety standards and to identify where improvements would be beneficial at justifiable cost. Krsko PSR project is structured in the three phases: Phase 1: Preparation of Detailed 10-years PSR Program, Phase 2: Performing of 10-years PSR Program and preparing of associated documents (2001-2003), and Phase 3: Implementation of the prioritized compensatory measures and modifications (development of associated EEAR, DMP, etc.) after agreement with the SNSA on the design, procedures and time-scales (2004-2008). This paper presents the NEK PSR results of work performed under Phase 2 focused on the ranking of safety issues and prioritization of corrective measures needed for establishing an efficient action plan. Safety issues were identified in Phase 2 during the following review processes: Periodic Safety Review (PSR) task; Krsko NPP Regulatory Compliance Program (RCP) review; Westinghouse Owner Group (WOG) catalog items screening/review; SNSA recommendations (including IAEA RAMP mission suggestions/recommendations).(author)

  19. Prioritization of design changes based on PSA

    International Nuclear Information System (INIS)

    Krajnc, B.; Mavko, B.

    1996-01-01

    Effective use of Probabilistic Safety Analyses (PSA) in the day to day plant operation is subject of intensive discussions among plant operators and regulators. There are several possible applications in which the PSA can be used, among those also to use the PSA approach for the quantification of influence of different proposed design changes to nuclear safety - influence on public safety - health. NPP Krsko is one of those plants that successfully completed its PSA project, with Level 1 and Level 2 analyses and effective know-how transfer. It also faces a number of regulatory and internally generated requirements for different design changes, mainly due to the fact that the plant is committed to continuous augmentation of nuclear safety. It is considered that the available tools and knowledge should be used and therefore applicable methodology should be developed for effective prioritization of proposed design changes by performing cost-benefit analyses for all major modifications - focusing on their influence on nuclear safety. Based on the above a new method for prioritization of design changes is proposed. The method uses Level 1 results (in the sense of plant damage states and their frequencies) directly as an input for further processing - first decision step to decide whether the proposed modification has or has no influence on nuclear safety. In Level 2 analyses the combination of probabilistic and deterministic approach was adopted. In fact the results of the deterministic analyses of severe accidents are treated in probabilistic manner due to large uncertainty of results. Finally to be able to perform plant specific cost benefit analyses so called partial Level 3 was defined. The proposed methods was preliminary tested and it gave favorable results. (author)

  20. HIV Testing

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... All Collapse All Should I get tested for HIV? CDC recommends that everyone between the ages of ...

  1. Assessing the effect of an online HIV/AIDS course on 1st-year ...

    African Journals Online (AJOL)

    Background. More international HIV/AIDS intervention initiatives targeting young adults are needed to help reach targets set by the Joint United Nations Programme on HIV and AIDS (UNAIDS). Objectives. To determine the effect of an online HIV/AIDS course on 1st-year pharmacy students' knowledge of HIV prevention and ...

  2. Technology Programme

    Energy Technology Data Exchange (ETDEWEB)

    Batistoni, Paola; De Marco, Francesco; Pieroni, Leonardo [ed.

    2005-07-01

    The technology activities carried out by the Euratom-ENEA Association in the framework of the European Fusion Development Agreement concern the Next Step (International Thermonuclear Experimental Reactor - ITER), the Long-Term Programme (breeder blanket, materials, International Fusion Materials Irradiation Facility - IFMIF), Power Plant Conceptual Studies and Socio-Economic Studies. The Underlying Technology Programme was set up to complement the fusion activities as well to develop technologies with a wider range of interest. The Technology Programme mainly involves staff from the Frascati laboratories of the Fusion Technical and Scientific Unit and from the Brasimone laboratories of the Advanced Physics Technologies Unit. Other ENEA units also provide valuable contributions to the programme. ENEA is heavily engaged in component development/testing and in design and safety activities for the European Fusion Technology Programme. Although the work documented in the following covers a large range of topics that differ considerably because they concern the development of extremely complex systems, the high level of integration and coordination ensures the capability to cover the fusion system as a whole. In 2004 the most significant testing activities concerned the ITER primary beryllium-coated first wall. In the field of high-heat-flux components, an important achievement was the qualification of the process for depositing a copper liner on carbon fibre composite (CFC) hollow tiles. This new process, pre-brazed casting (PBC), allows the hot radial pressing (HRP) joining procedure to be used also for CFC-based armour monoblock divertor components. The PBC and HRP processes are candidates for the construction of the ITER divertor. In the materials field an important milestone was the commissioning of a new facility for chemical vapour infiltration/deposition, used for optimising silicon carbide composite (SiCf/SiC) components. Eight patents were deposited during 2004

  3. Technology Programme

    International Nuclear Information System (INIS)

    Batistoni, Paola; De Marco, Francesco; Pieroni, Leonardo

    2005-01-01

    The technology activities carried out by the Euratom-ENEA Association in the framework of the European Fusion Development Agreement concern the Next Step (International Thermonuclear Experimental Reactor - ITER), the Long-Term Programme (breeder blanket, materials, International Fusion Materials Irradiation Facility - IFMIF), Power Plant Conceptual Studies and Socio-Economic Studies. The Underlying Technology Programme was set up to complement the fusion activities as well to develop technologies with a wider range of interest. The Technology Programme mainly involves staff from the Frascati laboratories of the Fusion Technical and Scientific Unit and from the Brasimone laboratories of the Advanced Physics Technologies Unit. Other ENEA units also provide valuable contributions to the programme. ENEA is heavily engaged in component development/testing and in design and safety activities for the European Fusion Technology Programme. Although the work documented in the following covers a large range of topics that differ considerably because they concern the development of extremely complex systems, the high level of integration and coordination ensures the capability to cover the fusion system as a whole. In 2004 the most significant testing activities concerned the ITER primary beryllium-coated first wall. In the field of high-heat-flux components, an important achievement was the qualification of the process for depositing a copper liner on carbon fibre composite (CFC) hollow tiles. This new process, pre-brazed casting (PBC), allows the hot radial pressing (HRP) joining procedure to be used also for CFC-based armour monoblock divertor components. The PBC and HRP processes are candidates for the construction of the ITER divertor. In the materials field an important milestone was the commissioning of a new facility for chemical vapour infiltration/deposition, used for optimising silicon carbide composite (SiCf/SiC) components. Eight patents were deposited during 2004

  4. Prioritizing and optimizing sustainable measures for food waste prevention and management.

    Science.gov (United States)

    Cristóbal, Jorge; Castellani, Valentina; Manfredi, Simone; Sala, Serenella

    2018-02-01

    Food waste has gained prominence in the European political debate thanks to the recent Circular Economy package. Currently the waste hierarchy, introduced by the Waste Framework Directive, has been the rule followed to prioritize food waste prevention and management measures according to the environmental criteria. But when considering other criteria along with the environmental one, such as the economic, other tools are needed for the prioritization and optimization. This paper addresses the situation in which a decision-maker has to design a food waste prevention programme considering the limited economic resources in order to achieve the highest environmental impact prevention along the whole food life cycle. A methodology using Life Cycle Assessment and mathematical programing is proposed and its capabilities are shown through a case study. Results show that the order established in the waste hierarchy is generally followed. The proposed methodology revealed to be especially helpful in identifying "quick wins" - measures that should be always prioritized since they avoid a high environmental impact at a low cost. Besides, in order to aggregate the environmental scores related to a variety of impact categories, different weighting sets were proposed. In general, results show that the relevance of the weighting set in the prioritization of the measures appears to be limited. Finally, the correlation between reducing food waste generation and reducing environmental impact along the Food Supply Chain has been studied. Results highlight that when planning food waste prevention strategies, it is important to set the targets at the level of environmental impact instead of setting the targets at the level of avoided food waste generation (in mass). Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  5. Riiklike tervishoiuprogrammide juhtimine narkomaania riikliku ennetamise programmi ja HIV/AIDSi riikliku ennetamise programmi näidetel : [bakalaureusetöö] / Helen Trelin ; Õigusinstituut ; juhendaja: Eduard Raska

    Index Scriptorium Estoniae

    Trelin, Helen

    2002-01-01

    Avalik sektor ja tänapäeva juhtimise põhimõtted, narkomaania ja HIV/AIDS riiklikud tervishoiuprogrammid, programmide juhtimine, alkoholismi ja narkomaania ennetamise programm 1997-2007, HIV/AIDS ennetamise riiklik programm 2002-2006

  6. ExpoCast: Exposure Science for Prioritization and Toxicity Testing

    Science.gov (United States)

    The US EPA is completing the Phase I pilot for a chemical prioritization research program, called ToxCastTM. Here EPA is developing methods for using computational chemistry, high-throughput screening, and toxicogenomic technologies to predict potential toxicity and prioritize l...

  7. 78 FR 69839 - Building Technologies Office Prioritization Tool

    Science.gov (United States)

    2013-11-21

    ... standards and building codes to ensure energy savings within buildings. BTO has developed a new technology... DEPARTMENT OF ENERGY Building Technologies Office Prioritization Tool AGENCY: Office of Energy....S. Department of Energy's (DOE) Building Technologies Office (BTO) developed the Prioritization Tool...

  8. False memory and importance: can we prioritize encoding without consequence?

    Science.gov (United States)

    Bui, Dung C; Friedman, Michael C; McDonough, Ian M; Castel, Alan D

    2013-10-01

    Given the large amount of information that we encounter, we often must prioritize what information we attempt to remember. Although critical for everyday functioning, relatively little research has focused on how people prioritize the encoding of information. Recent research has shown that people can and do selectively remember information assigned with higher, relative to lower, importance. However, the mechanisms underlying this prioritization process and the consequences of these processes are still not well understood. In the present study, we sought to better understand these prioritization processes and whether implementing these processes comes at the cost of memory accuracy, by increasing false memories. We used a modified form of the Deese/Roediger-McDermott (DRM) paradigm, in which participants studied DRM lists, with each list paired with low, medium, or high point values. In Experiment 1, encoding higher values led to more false memories than did encoding lower values, possibly because prioritizing information enhanced relational processing among high-value words. In Experiment 2, disrupting relational processing selectively reduced false memories for high-value words. Finally, in Experiment 3, facilitating relational processing selectively increased false memories for low-value words. These findings suggest that while prioritizing information can enhance true memory, this process concomitantly increases false memories. Furthermore, the mechanism underlying these prioritization processes depends on the ability to successfully engage in relational processing. Thus, how we prioritize the encoding of incoming information can come at a cost in terms of accurate memory.

  9. Contextual Requirements Prioritization and its Application to Smart Homes

    NARCIS (Netherlands)

    Sernani, Paolo; Dragoni, Aldo Franco; Serral, Estefanía; Dalpiaz, Fabiano

    2017-01-01

    When many requirements co-exist for a given system, prioritization is essential to determine which ones have higher priority. While the basic prioritization algorithms result in a total or partial order of the requirements, it is often the case that the priority of the requirements depends on the

  10. Cost-Prioritized Droop Schemes for Autonomous AC Microgrids

    DEFF Research Database (Denmark)

    Nutkani, Inam Ullah; Loh, Poh Chiang; Wang, Peng

    2015-01-01

    This paper presents two cost-prioritized droop sche- mes for distributed generators (DGs) in a rural or islanded microgrid. Dispatch prioritization of the schemes allows autonomous identification of the appropriate DGs for generation, in accordance to the overall load conditions of the microgrid....

  11. Asymptotic performance modelling of DCF protocol with prioritized channel access

    Science.gov (United States)

    Choi, Woo-Yong

    2017-11-01

    Recently, the modification of the DCF (Distributed Coordination Function) protocol by the prioritized channel access was proposed to resolve the problem that the DCF performance worsens exponentially as more nodes exist in IEEE 802.11 wireless LANs. In this paper, an asymptotic analytical performance model is presented to analyze the MAC performance of the DCF protocol with the prioritized channel access.

  12. Decision making in prioritization of required operational capabilities

    Science.gov (United States)

    Andreeva, P.; Karev, M.; Kovacheva, Ts.

    2015-10-01

    The paper describes an expert heuristic approach to prioritization of required operational capabilities in the field of defense. Based on expert assessment and by application of the method of Analytical Hierarchical Process, a methodology for their prioritization has been developed. It has been applied to practical simulation decision making games.

  13. Sensitivity and uncertainty analyses in aging risk-based prioritizations

    International Nuclear Information System (INIS)

    Hassan, M.; Uryas'ev, S.; Vesely, W.E.

    1993-01-01

    Aging risk evaluations of nuclear power plants using Probabilistic Risk Analyses (PRAs) involve assessments of the impact of aging structures, systems, and components (SSCs) on plant core damage frequency (CDF). These assessments can be used to prioritize the contributors to aging risk reflecting the relative risk potential of the SSCs. Aging prioritizations are important for identifying the SSCs contributing most to plant risk and can provide a systematic basis on which aging risk control and management strategies for a plant can be developed. However, these prioritizations are subject to variabilities arising from uncertainties in data, and/or from various modeling assumptions. The objective of this paper is to present an evaluation of the sensitivity of aging prioritizations of active components to uncertainties in aging risk quantifications. Approaches for robust prioritization of SSCs also are presented which are less susceptible to the uncertainties

  14. Aggressive effects of prioritizing popularity in early adolescence.

    Science.gov (United States)

    Cillessen, Antonius H N; Mayeux, Lara; Ha, Thao; de Bruyn, Eddy H; LaFontana, Kathryn M

    2014-01-01

    This study examined the moderating effects of prioritizing popularity on the association between early adolescents' popularity and their aggressive, leadership, and prosocial behaviors with peers. Participants were 288 14-year-olds from The Netherlands who completed a sociometric instrument and an assessment of how much they prioritized popularity over other personal goals. Results indicated that prioritizing popularity was distinct from actual popularity in the peer group. Further, prioritizing popularity moderated the association of popularity with aggressive and leadership behaviors, with adolescents who were both popular and who prioritized popularity being particularly aggressive and scoring high on leadership behaviors. This trend was especially true for boys. The same moderating effect was not found for prosocial behaviors. Motivational and social-cognitive factors in the dynamics of peer popularity are highlighted. © 2013 Wiley Periodicals, Inc.

  15. HIV sero-conversion during late pregnancy – when to retest

    Directory of Open Access Journals (Sweden)

    Emma Kalk

    2013-06-01

    Full Text Available The South African National Prevention of Mother-to-Child Transmission of HIV programme has resulted in significant reductions in vertical transmission, but new infant HIV infections continue to occur. We present two cases of HIV seroconversion during late pregnancy, demonstrating the limitations of the current programme. These could be mitigated by expanding the programme to include maternal testing at delivery and at immunisation clinic visits as we pursue the elimination of mother-to-child transmission.

  16. The promises and challenges of pre-exposure prophylaxis as part of the emerging paradigm of combination HIV prevention.

    Science.gov (United States)

    Cáceres, Carlos F; Koechlin, Florence; Goicochea, Pedro; Sow, Papa-Salif; O'Reilly, Kevin R; Mayer, Kenneth H; Godfrey-Faussett, Peter

    2015-01-01

    Towards the end of the twentieth century, significant success was achieved in reducing incidence in several global HIV epidemics through ongoing prevention strategies. However, further progress in risk reduction was uncertain. For one thing, it was clear that social vulnerability had to be addressed, through research on interventions addressing health systems and other structural barriers. As soon as antiretroviral treatment became available, researchers started to conceive that antiretrovirals might play a role in decreasing either susceptibility in uninfected people or infectiousness among people living with HIV. In this paper we focus on the origin, present status, and potential contribution of pre-exposure prophylaxis (PrEP) within the combination HIV prevention framework. After a phase of controversy, PrEP efficacy trials took off. By 2015, daily oral PrEP, using tenofovir alone or in combination with emtricitabine, has been proven efficacious, though efficacy seems heavily contingent upon adherence to pill uptake. Initial demonstration projects after release of efficacy results have shown that PrEP can be implemented in real settings and adherence can be high, leading to high effectiveness. Despite its substantial potential, beliefs persist about unfeasibility in real-life settings due to stigma, cost, adherence, and potential risk compensation barriers. The strategic synergy of behavioural change communication, biomedical strategies (including PrEP), and structural programmes is providing the basis for the combination HIV prevention framework. If PrEP is to ever become a key component of that framework, several negative beliefs must be confronted based on emerging evidence; moreover, research gaps regarding PrEP implementation must be filled, and appropriate prioritization strategies must be set up. Those challenges are significant, proportional to the impact that PrEP implementation may have in the global response to HIV.

  17. Pre-exposure prophylaxis for HIV-negative persons with partners living with HIV: uptake, use, and effectiveness in an open-label demonstration project in East Africa.

    Science.gov (United States)

    Heffron, Renee; Ngure, Kenneth; Odoyo, Josephine; Bulya, Nulu; Tindimwebwa, Edna; Hong, Ting; Kidoguchi, Lara; Donnell, Deborah; Mugo, Nelly R; Bukusi, Elizabeth A; Katabira, Elly; Asiimwe, Stephen; Morton, Jennifer; Morrison, Susan; Haugen, Harald; Mujugira, Andrew; Haberer, Jessica E; Ware, Norma C; Wyatt, Monique A; Marzinke, Mark A; Frenkel, Lisa M; Celum, Connie; Baeten, Jared M

    2017-11-06

    Introduction : Pre-exposure prophylaxis (PrEP) can provide high protection against HIV infection and is a recommended intervention for HIV-negative persons with substantial HIV risk, such as individuals with a partner living with HIV.  Demonstration projects of PrEP have been conducted in diverse settings worldwide to illustrate practical examples of how PrEP can be delivered.  Methods : We evaluated delivery of PrEP for HIV-negative partners within heterosexual HIV serodiscordant couples in an open-label demonstration project in East Africa.  The delivery model integrated PrEP into HIV treatment services, prioritizing PrEP for HIV-negative partners within serodiscordant couples prior to and during the first 6 months after the partner living with HIV initiated antiretroviral therapy (ART).  We measured adherence to PrEP through medication event monitoring system (MEMS) bottle caps and quantification of tenofovir in plasma among a random sample of participants. We estimated HIV infections prevented using a counterfactual cohort simulated from the placebo arm of a previous PrEP clinical trial. Results : We enrolled 1,010 HIV serodiscordant couples that were naïve to ART and PrEP.  Ninety-seven percent (97%) of HIV-negative partners initiated PrEP, and when PrEP was dispensed, objective measures suggest high adherence: 71% of HIV-negative participants took ≥80% of expected doses, as recorded via MEMS, and 81% of plasma samples had tenofovir detected.  A total of 4 incident HIV infections were observed (incidence rate=0.24 per 100 person-years), a 95% reduction (95% CI 86-98%, pproject for African HIV-negative individuals whose partners were known to be living with HIV.  Delivery of PrEP to HIV-negative partners within HIV serodiscordant couples was feasible and should be prioritized for wide-scale implementation.

  18. Envisioning Women-Centered HIV Care: Perspectives from Women Living with HIV in Canada.

    Science.gov (United States)

    O'Brien, Nadia; Greene, Saara; Carter, Allison; Lewis, Johanna; Nicholson, Valerie; Kwaramba, Gladys; Ménard, Brigitte; Kaufman, Elaina; Ennabil, Nourane; Andersson, Neil; Loutfy, Mona; de Pokomandy, Alexandra; Kaida, Angela

    Women comprise nearly one-quarter of people living with human immunodeficiency virus (HIV) in Canada. Compared with men, women living with HIV experience inequities in HIV care and health outcomes, prompting a need for gendered and tailored approaches to HIV care. Peer and academic researchers from the Canadian HIV Women's Sexual and Reproductive Health Cohort Study conducted focus groups to understand women's experience of seeking care, with the purpose of identifying key characteristics that define a women-centered approach to HIV care. Eleven focus groups were conducted with 77 women living with HIV across Quebec, Ontario, and British Columbia, Canada. Women envisioned three central characteristics of women-centered HIV care, including i) coordinated and integrated services that address both HIV and women's health care priorities, and protect against exclusion from care due to HIV-related stigma, ii) care that recognizes and responds to structural barriers that limit women's access to care, such as violence, poverty, motherhood, HIV-related stigma, and challenges to safe disclosure, and iii) care that fosters peer support and peer leadership in its design and delivery to honor the diversity of women's experiences, overcome women's isolation, and prioritize women's ownership over the decisions that affect their lives. Despite advances in HIV treatment and care, the current care landscape is inadequate to meet women's comprehensive care needs. A women-centered approach to HIV care, as envisioned by women living with HIV, is central to guiding policy and practice to improve care and outcomes for women living with HIV in Canada. Copyright © 2017 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  19. Prioritizing emerging zoonoses in the Netherlands.

    Directory of Open Access Journals (Sweden)

    Arie H Havelaar

    Full Text Available BACKGROUND: To support the development of early warning and surveillance systems of emerging zoonoses, we present a general method to prioritize pathogens using a quantitative, stochastic multi-criteria model, parameterized for the Netherlands. METHODOLOGY/PRINCIPAL FINDINGS: A risk score was based on seven criteria, reflecting assessments of the epidemiology and impact of these pathogens on society. Criteria were weighed, based on the preferences of a panel of judges with a background in infectious disease control. CONCLUSIONS/SIGNIFICANCE: Pathogens with the highest risk for the Netherlands included pathogens in the livestock reservoir with a high actual human disease burden (e.g. Campylobacter spp., Toxoplasma gondii, Coxiella burnetii or a low current but higher historic burden (e.g. Mycobacterium bovis, rare zoonotic pathogens in domestic animals with severe disease manifestations in humans (e.g. BSE prion, Capnocytophaga canimorsus as well as arthropod-borne and wildlife associated pathogens which may pose a severe risk in future (e.g. Japanese encephalitis virus and West-Nile virus. These agents are key targets for development of early warning and surveillance.

  20. Prioritizing Environmental Chemicals for Obesity and Diabetes ...

    Science.gov (United States)

    Background: Diabetes and obesity are major threats to public health in the US and abroad. Understanding the role chemicals in our environment play in the development of these conditions is an emerging issue in environmental health, although identifying and prioritizing chemicals for testing beyond those already implicated in the literature is a challenge. This review is intended to help researchers generate hypotheses about chemicals potentially contributing to diabetes and obesity-related health outcomes by summarizing relevant findings from the US Environmental Protection Agency (EPA) ToxCast high-throughput screening (HTS) program. Objectives: To develop new hypotheses around environmental chemicals of potential interest for diabetes- or obesity-related outcomes using high throughput screening data. Methods: Identify ToxCast assay targets relevant to several biological processes related to diabetes and obesity (insulin sensitivity in peripheral tissue, pancreatic islet and beta cell function, adipocyte dierentiation, and feeding behavior) and present chemical screening data against those assay targets to identify chemicals of potential interest. Discussion: Results of this screening-level analysis suggest that the spectrum of environmental chemicals to consider in research related to diabetes and obesity is much broader than indicated from research papers and reviews published in the peer-reviewed literature. Testing of hypotheses based on ToxCast data will a

  1. Prioritizing pesticide compounds for analytical methods development

    Science.gov (United States)

    Norman, Julia E.; Kuivila, Kathryn; Nowell, Lisa H.

    2012-01-01

    The U.S. Geological Survey (USGS) has a periodic need to re-evaluate pesticide compounds in terms of priorities for inclusion in monitoring and studies and, thus, must also assess the current analytical capabilities for pesticide detection. To meet this need, a strategy has been developed to prioritize pesticides and degradates for analytical methods development. Screening procedures were developed to separately prioritize pesticide compounds in water and sediment. The procedures evaluate pesticide compounds in existing USGS analytical methods for water and sediment and compounds for which recent agricultural-use information was available. Measured occurrence (detection frequency and concentrations) in water and sediment, predicted concentrations in water and predicted likelihood of occurrence in sediment, potential toxicity to aquatic life or humans, and priorities of other agencies or organizations, regulatory or otherwise, were considered. Several existing strategies for prioritizing chemicals for various purposes were reviewed, including those that identify and prioritize persistent, bioaccumulative, and toxic compounds, and those that determine candidates for future regulation of drinking-water contaminants. The systematic procedures developed and used in this study rely on concepts common to many previously established strategies. The evaluation of pesticide compounds resulted in the classification of compounds into three groups: Tier 1 for high priority compounds, Tier 2 for moderate priority compounds, and Tier 3 for low priority compounds. For water, a total of 247 pesticide compounds were classified as Tier 1 and, thus, are high priority for inclusion in analytical methods for monitoring and studies. Of these, about three-quarters are included in some USGS analytical method; however, many of these compounds are included on research methods that are expensive and for which there are few data on environmental samples. The remaining quarter of Tier 1

  2. Impact of National HIV and AIDS Communication Campaigns in South Africa to Reduce HIV Risk Behaviour

    Directory of Open Access Journals (Sweden)

    Karl Peltzer

    2012-01-01

    Full Text Available In South Africa social and behavioural communication interventions are a critical component of HIV/AIDS prevention, and numerous communication campaigns have been implemented intensively across the country through government initiatives and nongovernmental organisations over the past decade. The aim of this paper is to assess the reach of HIV and AIDS communication campaigns in conjunction with contributions to knowledge, attitudes, and HIV risk behaviours in the general population in South Africa. The sample included in this nationally representative cross-sectional survey was 13234 people aged 15–55 years. Overall, the study found that there was high exposure to 18 different HIV communication programmes (median 6 programmes and 14 programmes more than 30% across different age groups. Most programmes were more often seen or heard by young people aged between 15 and 24 years. In multivariate analysis, greater exposure to HIV mass communication programmes was associated with greater HIV knowledge, condom use at last sex, having tested for HIV in the past 12 months, and less stigmatizing attitude toward PLWHA.

  3. Premarital HIV screening in Johor--(2002-2004).

    Science.gov (United States)

    Khebir, B V; Adam, M A; Daud, A R; Shahrom, C M D

    2007-03-01

    A descriptive study was conducted on premarital HIV screening programme in Johor over a three year period. HIV screenings were done at government clinics and confirmed by accredited laboratories. As a result, 123 new HIV cases were detected (0.17%) from 74,210 respondents. In 2004, 24 cases (64.9%) advanced to marriage (n = 37) after they underwent counselling and six of them married among themselves. Positivity rate from this programme (0.17%) is higher than antenatal screening (0.05%). Despite the implementation of the premarital HIV screening programme, marriage application in Johor rose 2.8% in 2004 compared with 2002. This programme had partly contributed to public awareness against HIV and provides another option in early detection of the disease.

  4. ISOLDE PROGRAMME

    CERN Multimedia

    Fedosseev, V; Herfurth, F; Scheidenberger, C; Geppert, C; Gorges, C; Ratajczyk, T; Wiederhold, J C; Vogel, S; Munch, M K; Nieminen, P; Pakarinen, J J A; Lecesne, N; Bouzomita, H; Grinyer, J; Marques moreno, F M; Parlog, M; Blank, B A; Pedroza, J; Ghetta, V; Lozeva, R; Zacarias, S M; Guillemaud mueller, D S; Cottereau, E; Cheikh mhamed, M; Tusseau nenez, S; Tungate, G; Walker, P M; Smith, A G; Fitzpatrick, C; Dominik, W M; Karny, M; Ciemny, A A; Nyman, G H; Thies, R M A; Lindberg, S K G; Langouche, G F; Velten, P; Araujo escalona, V I; Boudreau, M; Domnanich, K A; Richter, D; Lutter, R J; Javaji, A; Engel, R Y; Wiehr, S; Nacher gonzalez, E; Jungclaus, A; Ribeiro jimenez, G; Marroquin alonso, I; Cal gonzalez, J; Paziy, V; Salsac, M; Murphy, C; Podolyak, Z F; Bajoga, A D; Butler, P; Pritchard, A; Colosimo, S J; Steer, A N; Fox, S P; Wadsworth, B A; Truesdale, V L; Al monthery, M; Bracco, A; Guttormsen, M S; Badea, M N; Calinescu, S; Ujeniuc, S; Cederkall, J A; Zemlyanoy, S; Donets, E D; Golovkov, M; Schweitzer, D K; Vranicar, A; Harrichunder, S; Ncube, M; Nannini, A; Strisovska, J; Wolf, E; Gerten, R F; Lehnert, J; Rainovski, G I; Pospisil, S; Datta pramanik, U; Benzoni, G; Fedorov, D; Maier, F M; Bonanni, A; Pfeiffer, B; Griesel, T; Wehner, L W; Mikkelsen, M; Recchia, F; Lenzi, S M; Smith, J F; Kelly, C M; Acosta sanchez, L A; Chavez lomeli, E R; De melo bandeira tavares, P M; Vieira, J M; Martins da silva, M A; Lima lopes, A M; Lopes leal, T J; Mader, J; Kessler, P; Laurent, B G; Schweikhard, L C; Marx, G H; Kulczycka, E; Komorowska, M; Da silva, M F; Goncalves marques, C P; Baptista peres, M A; Welander, J E; Reiter, P; Miller, C; Martin sanchez-cano, D; Wiens, A; Blazhev, A A; Braun, N; Cappellazzo, M V; Birkenbach, B; Gerst, R; Dannhoff, M F; Sithole, M J; Bilgier, B; Nardelli, S; Araujo mendes, C M; Agramunt ros, J; Valencia marin, E; Pantea, E; Hessberger, F P; Leduc, A J; Mitsuoka, S; Carbonari, A W; Buchegger, F J; Garzon camacho, A; Dapo, H; Papka, P; Stachura, M K; 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Green, B L; Keatings, J M; Kuti, I; Halasz, Z; Henry, M O; Bras de sequeira amaral, V; Espirito santo, F; Da silva, D J; Rosendahl, S; Vianden, R J; Speidel, K; Agarwal, I; Faul, T; Kownacki, J M; Martins correia, J G; Lorenz, K; Costa miranda, S M; Granadeiro costa, A R; Zyabkin, D; Kotthaus, T; Pfeiffer, M; Gironi, L; Jensen, A; Romstedt, F; Constantino silva furtado, I; Heredia cardona, J A; Jordan martin, M D; Montaner piza, A; Zacate, M O; Plewinski, F; Mesli, A; Akakpo, E H; Pichard, A; Hergemoller, F; Neu, W; Fallis starhunter, J P; Voulot, D; Mrazek, J; Ugryumov, V; Savreux, R P; Kojouharov, I M; Kern, R O; Papst, O; Fitting, J; Lauer, M; Kirsebom, O S; Jensen, K L; Jokinen, A; Rahkila, P J; Hager, U D K; Konki, J P; Dubois, M; Orr, N A; Fabian, X; Huikari, J E; Goigoux, T; Magron, C; Zakari, A A; Maietta, M; Bachelet, C E M; Roussiere, B; Li, R; Canavan, R L; Lorfing, C; Foster, R M; Gislason, H P; Shayestehaminzadeh, S; Qi, B; Mukai, M; Watanabe, Y; Willmann, L; Kurcewicz, W; 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Bhattacharya, P; Roy, S; Rahaman, M A; Wlodarski, T; Carvalho soares, J; Barzakh, A; Schertz, F; Froemmgen, N E; Liberati, V; Foy, B E; Baptista barbosa, M; Weinheimer, C P; Zboril, M; Simon, R E; Popescu, L A; Czosnyka, T; Miranda jana, P A; Leimbach, D; Naskrecki, R; Plociennik, W A; Ruchowska, E E; Chiara, C J; Walters, W; Eberth, J H; Thomas, T; Thole, P; Queiser, M T; Lo bianco, G; D'amico, F; Muller, S; Sanchez alarcon, R M; Tain enriquez, J L; Orrigo, S E A; Orlandi, R; Masango, S; Plazaola muguruza, F C; Lepareur, N G; Fiebig, J M; Ceylan, N; Wildner, E; Kowalska, M; Malbrunot, S; Garcia ruiz, R F; Pallada, S; Slezak, M; Roeckl, E; Schrieder, G H; Ilieva, S K; Koenig, K L; Amoretti, M A; Lommen, J M; Fynbo, H O U; Weyer, G O P; Koldste, G T; Madsboll, K; Jensen, J H; Nieminen, A M; Reponen, M; Villari, A; Thomas, J; Saint-laurent, M; Sorlin, O H; Carniol, B; Pereira lopez, J; Grevy, S; Plaisir, C; Marie-jeanne, M J; Georgiev, G P; Etile, A M; Le blanc, F M; Verney, D; Stefan, G I; 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Gaudefroy, L; Chevrier, R; Szunyogh, D M; Napiorkowski, P J; Wrzosek-lipska, K; Wahl, U; Catarino, N; Pereira carvalho alves de sequeira, M; Hess, H E; Holler, A; Bettermann, L; Geibel, K; Taprogge, J; Lewandowski, L T N; Manchado de sola, F; Cakirli mutlu, R B; Das gupta, S; Thulstrup, P W; Heinz, U; Nogwanya, T; Neidherr, D M; Morales lopez, A I; Gumenyuk, O; Peaker, A R; Wakabayashi, Y; Abrahams, K J; Martin montes, E J; Mach, H A; Souza ribeiro junior, I; He, J; Chalil, A; Xing, R; Dos santos augusto, R M; Giles, T J; Dorsival, A; Trujillo hernandez, J S; Kalaninova, Z; Andel, B; Venos, D; Kraemer, J; Saha, S; Neugart, R; Eronen, T O; Kreim, K D; Heck, M K; Goncharov, M; Karthein, J; Julin, R J; Eleon, C; Achouri, N L; Grinyer, G F; Fontbonne, C M; Alfaurt, P; Lynch, K M; Wilkins, S G; Brown, A R; Imai, N; Pomorski, M J; Janiak, L; Nilsson, T; Stroke, H H; Stanja, J; Dangelser, E; Heenen, P; Godefroid, M; Mallion, S N; Gins, W A M; Stegemann, S T; Koszorus, A; Mcnulty, J F; Lin, P; 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Boztosun, I; Van zyl, J J; Catherall, R; Lettry, J; Wenander, F J C; Zakoucky, D; Catchen, G L; Noertershaeuser, W; Kroell, T; Leske, J; Shubina, D; Murray, I M; Pancin, J; Delaunay, F; Poincheval, J J L; Audirac, L L; Gerbaux, M T; Aouadi, M; Sole, P G P; Fallot, M P; Onillon, A; Duchemin, C; Formento cavaier, R; Audi, G; Boukhari, A; Lau, C; Martin, J A; Barre, N H; Berry, T A; Procter, T J; Bladen, L K; Axiotis, M; Muto, S; Jeong, S C; Hirayama, Y; Korgul, A B; Minamisono, K; Bingham, C R; Aprahamian, A; Bucher, B M; Severijns, N; Huyse, M L; Ferrer garcia, R; Verlinde, M N S; Romano, N; Maugeri, E A; Klupp, S C; Dehn, M H; Heinke, R M; Naubereit, P; Maira vidal, A; Vedia fernandez, M V; Ibanez garcia, P B; Bruyneel, B J E; Materna, T; Hadynska-klek, K; Al-dahan, N; Alazemi, N; Carroll, R J; Babcock, C; Patronis, N; Eleme, Z; Dhal, A; Sahin, E; Goergen, A; Maj, A; Bednarczyk, P A; Borcea, C; Negoita, F; Suliman, G; Marginean, N M; Sotty, C O; Negret, A L; Nae, S A; Nita, C; Golubev, P I; Knyazev, A; Jost, C U; Petrik, K; Vaeyrynen, S A; Dracoulis, G D; Uher, J; Fernandez dominguez, B; Chakraborty, P; Avigo, R; Falahat, S; Lekovic, F; Dorrer, H J; Mengoni, D; Derkx, X; Angus, L J; Sandhu, K S; Gregor, E; Kelly, N A; Byrne, D J; Haas, H; Lourenco, A A; Sousa pereira, S M; Sousa, J B; De melo mendonca, T M; Tavares de sousa, C; Guerreiro dos santos oliveira custodio, L M; Da rocha rodrigues, P M; Yamaguchi, T; Thompson, P C; Rosenbusch, M; Wienholtz, F; Fischer, P; Iwanicki, J S; Rusek, K M; Hanstorp, D; Vetter, U; Wolak, J M; Park, S H; Warr, N V; Doornenbal, P C; Imig, A; Seidlitz, M; Moschner, K; Vogt, A; Kaya, L; Martel bravo, I; Orduz, A K; Serot, O; Majola, S N; Litvinov, Y; Bommert, M; Hensel, S; Markevich, V; Nishio, K; Ota, S; Matos, I; Zenkevich, A; Picado sandi, E; Forstner, O; Hu, B; Ntshangase, S S; Sanchez-segovia, J

    2002-01-01

    The experiments aim at a broad exploration of the properties of atomic nuclei far away from the region of beta stability. Furthermore, the unique radioactive beams of over 60~elements produced at the on-line isotope separators ISOLDE-2 and ISOLDE-3 are used in a wide programme of atomic, solid state and surface physics. Around 300 scientists are involved in the project, coming from about 70 laboratories. \\\\ \\\\ The electromagnetic isotope separators are connected on-line with their production targets in the extracted 600 MeV proton or 910~MeV Helium-3 beam of the Synchro-Cyclotron. Secondary beams of radioactive isotopes are available at the facility in intensities of 10$^1

  5. Prioritizing genes associated with prostate cancer development

    International Nuclear Information System (INIS)

    Gorlov, Ivan P; Logothetis, Christopher J; Sircar, Kanishka; Zhao, Hongya; Maity, Sankar N; Navone, Nora M; Gorlova, Olga Y; Troncoso, Patricia; Pettaway, Curtis A; Byun, Jin Young

    2010-01-01

    The genetic control of prostate cancer development is poorly understood. Large numbers of gene-expression datasets on different aspects of prostate tumorigenesis are available. We used these data to identify and prioritize candidate genes associated with the development of prostate cancer and bone metastases. Our working hypothesis was that combining meta-analyses on different but overlapping steps of prostate tumorigenesis will improve identification of genes associated with prostate cancer development. A Z score-based meta-analysis of gene-expression data was used to identify candidate genes associated with prostate cancer development. To put together different datasets, we conducted a meta-analysis on 3 levels that follow the natural history of prostate cancer development. For experimental verification of candidates, we used in silico validation as well as in-house gene-expression data. Genes with experimental evidence of an association with prostate cancer development were overrepresented among our top candidates. The meta-analysis also identified a considerable number of novel candidate genes with no published evidence of a role in prostate cancer development. Functional annotation identified cytoskeleton, cell adhesion, extracellular matrix, and cell motility as the top functions associated with prostate cancer development. We identified 10 genes--CDC2, CCNA2, IGF1, EGR1, SRF, CTGF, CCL2, CAV1, SMAD4, and AURKA--that form hubs of the interaction network and therefore are likely to be primary drivers of prostate cancer development. By using this large 3-level meta-analysis of the gene-expression data to identify candidate genes associated with prostate cancer development, we have generated a list of candidate genes that may be a useful resource for researchers studying the molecular mechanisms underlying prostate cancer development

  6. Health technology prioritization: which criteria for prioritizing new technologies and what are their relative weights?

    Science.gov (United States)

    Golan, Ofra; Hansen, Paul; Kaplan, Giora; Tal, Orna

    2011-10-01

    To review the criteria and 'other' considerations used internationally for prioritizing new health technologies, and to demonstrate a conjoint-analysis methodology (also known as discrete choice experiments) for deriving relative weights for the criteria. We searched the literature for criteria and other considerations for prioritizing new technologies. A convenience sample of 74 respondents completed a conjoint-analysis survey involving criteria related to technologies' 'benefits'. Encompassing 11 countries and the US state of Oregon, we were able to distinguish three main groups of criteria: (a) Need, appropriateness and clinical benefits; (b) Efficiency (including cost-effectiveness); and (c) Equality, solidarity and other ethical or social values. For several countries, the quality of the clinical and economic evidence and factors related to strategic issues and procedural justice respectively are also considered. The criteria and their weights from the conjoint-analysis survey are: 'Lives saved'=0.343, 'Life-prolongation benefits'=0.243, 'Quality-of-life gains'=0.217, a criterion representing the availability of alternative treatments=0.107, and 'Other important social/ethical benefits'=0.087. The criteria represent a pluralistic combination of needs-based, maximizing and egalitarian principles, and we demonstrated a methodology for deriving the weights for criteria related to technologies' 'benefits'. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Cross-modal project prioritization : a TPCB peer exchange.

    Science.gov (United States)

    2015-05-01

    This report highlights key recommendations and best practices identified at the peer exchange on Cross-Modal Project Prioritization, held on December 16 and 17, 2014, in Raleigh, North Carolina. This event was sponsored by the Transportation Planning...

  8. Prioritizing connection requests in GMPLS-controlled optical networks

    DEFF Research Database (Denmark)

    Ruepp, Sarah Renée; Koster, A.; Andriolli, N.

    2009-01-01

    We prioritize bidirectional connection requests by combining dynamic connection provisioning with off-line optimization. Results show that the proposed approach decreases wavelength-converter usage, thereby allowing operators to reduce blocking-probably under bulk connection assignment or network...

  9. HIV/AIDS in Asia.

    Science.gov (United States)

    Ruxrungtham, Kiat; Brown, Tim; Phanuphak, Praphan

    HIV (ie, HIV-1) epidemics in Asia show great diversity, both in severity and timing. But epidemics in Asia are far from over and several countries including China, Indonesia, and Vietnam have growing epidemics. Several factors affect the rate and magnitude of growth of HIV prevalence, but two of the most important are the size of the sex worker population and the frequency with which commercial sex occurs. In view of the present state of knowledge, even countries with low prevalence of infection might still have epidemics affecting a small percentage of the population. Once HIV infection has become established, growing needs for care and treatment are unavoidable and even the so-called prevention-successful countries of Thailand and Cambodia are seeing burgeoning care needs. The manifestations of HIV disease in the region are discussed with the aim of identifying key issues in medical management and care of HIV/AIDS. In particular, issues relevant to developing appropriate highly active antiretroviral treatment programmes in the region are discussed. Although access to antiretroviral therapy is increasing globally, making it work effectively while simultaneously expanding prevention programmes to stem the flow of new infections remains a real challenge in Asia. Genuine political interest and commitment are essential foundations for success, demanding advocacy at all levels to drive policy, mobilise sufficient resources, and take effective action.

  10. Technology programme

    International Nuclear Information System (INIS)

    2007-01-01

    The technology activities carried out by the EURATOM-ENEA Association concern the continuation of the European Fusion Development Agreement (EFDA) as well as the ITER activities coordinated by the ITER International Office and Fusion for Energy. Also included in the activities are design and RD under the Broader Approach Agreement between the EU and Japan. In order to better contribute to the programme a number of consortium agreements among the Associations are being signed. Collaboration with industries in view of their participation in the construction of ITER was further strengthened, mainly in the field of magnet and divertor components. The new European Test Blanket Facility at ENEA Brasimone was completed; the design of the ITER radial neutron camera was optimised and the performance achievable with the in-vessel viewing system was further assessed by experimental trials. Design activities for the JT-60SA magnet and power supply system as well as the design and experimental activities related to the target of the International Fusion Materials Irradiation Facility were continued. Significant work was done to define quality assurance for neutronics analyses. Mockups of the ITER pre-compression ring made in glass fibre epoxy were tested. The activities and results documented in the following illustrate ENEA's efforts to support fusion development

  11. Patient-centered prioritization of bladder cancer research.

    Science.gov (United States)

    Smith, Angela B; Chisolm, Stephanie; Deal, Allison; Spangler, Alejandra; Quale, Diane Z; Bangs, Rick; Jones, J Michael; Gore, John L

    2018-05-04

    Patient-centered research requires the meaningful involvement of patients and caregivers throughout the research process. The objective of this study was to create a process for sustainable engagement for research prioritization within oncology. From December 2014 to 2016, a network of engaged patients for research prioritization was created in partnership with the Bladder Cancer Advocacy Network (BCAN): the BCAN Patient Survey Network (PSN). The PSN leveraged an online bladder cancer community with additional recruitment through print advertisements and social media campaigns. Prioritized research questions were developed through a modified Delphi process and were iterated through multidisciplinary working groups and a repeat survey. In year 1 of the PSN, 354 patients and caregivers responded to the research prioritization survey; the number of responses increased to 1034 in year 2. The majority of respondents had non-muscle-invasive bladder cancer (NMIBC), and the mean time since diagnosis was 5 years. Stakeholder-identified questions for noninvasive, invasive, and metastatic disease were prioritized by the PSN. Free-text questions were sorted with thematic mapping. Several questions submitted by respondents were among the prioritized research questions. A final prioritized list of research questions was disseminated to various funding agencies, and a highly ranked NMIBC research question was included as a priority area in the 2017 Patient-Centered Outcomes Research Institute announcement of pragmatic trial funding. Patient engagement is needed to identify high-priority research questions in oncology. The BCAN PSN provides a successful example of an engagement infrastructure for annual research prioritization in bladder cancer. The creation of an engagement network sets the groundwork for additional phases of engagement, including design, conduct, and dissemination. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  12. Stroke: Working toward a Prioritized World Agenda

    Science.gov (United States)

    Hachinski, Vladimir; Donnan, Geoffrey A.; Gorelick, Philip B.; Hacke, Werner; Cramer, Steven C.; Kaste, Markku; Fisher, Marc; Brainin, Michael; Buchan, Alastair M.; Lo, Eng H.; Skolnick, Brett E.; Furie, Karen L.; Hankey, Graeme J.; Kivipelto, Miia; Morris, John; Rothwell, Peter M.; Sacco, Ralph L.; Smith, Jr., Sidney C.; Wang, Yulun; Bryer, Alan; Ford, Gary A.; Iadecola, Costantino; Martins, Sheila C.O.; Saver, Jeff; Skvortsova, Veronika; Bayley, Mark; Bednar, Martin M.; Duncan, Pamela; Enney, Lori; Finklestein, Seth; Jones, Theresa A.; Kalra, Lalit; Kleim, Jeff; Nitkin, Ralph; Teasell, Robert; Weiller, Cornelius; Desai, Bhupat; Goldberg, Mark P.; Heiss, Wolf-Dieter; Saarelma, Osmo; Schwamm, Lee H.; Shinohara, Yukito; Trivedi, Bhargava; Wahlgren, Nils; Wong, Lawrence K.; Hakim, Antoine; Norrving, Bo; Prudhomme, Stephen; Bornstein, Natan M.; Davis, Stephen M.; Goldstein, Larry B.; Leys, Didier; Tuomilehto, Jaakko

    2010-01-01

    Background and Purpose The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Methods Preliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Results Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent ‘silo’ mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (e.g., social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build

  13. Stroke: working toward a prioritized world agenda.

    Science.gov (United States)

    Hachinski, Vladimir; Donnan, Geoffrey A; Gorelick, Philip B; Hacke, Werner; Cramer, Steven C; Kaste, Markku; Fisher, Marc; Brainin, Michael; Buchan, Alastair M; Lo, Eng H; Skolnick, Brett E; Furie, Karen L; Hankey, Graeme J; Kivipelto, Miia; Morris, John; Rothwell, Peter M; Sacco, Ralph L; Smith, Sidney C; Wang, Yulun; Bryer, Alan; Ford, Gary A; Iadecola, Costantino; Martins, Sheila C O; Saver, Jeff; Skvortsova, Veronika; Bayley, Mark; Bednar, Martin M; Duncan, Pamela; Enney, Lori; Finklestein, Seth; Jones, Theresa A; Kalra, Lalit; Kleim, Jeff; Nitkin, Ralph; Teasell, Robert; Weiller, Cornelius; Desai, Bhupat; Goldberg, Mark P; Heiss, Wolf-Dieter; Saarelma, Osmo; Schwamm, Lee H; Shinohara, Yukito; Trivedi, Bhargava; Wahlgren, Nils; Wong, Lawrence K; Hakim, Antoine; Norrving, Bo; Prudhomme, Stephen; Bornstein, Natan M; Davis, Stephen M; Goldstein, Larry B; Leys, Didier; Tuomilehto, Jaakko

    2010-01-01

    The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Preliminary work was performed by 7 working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent 'silo' mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (e.g., social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized electronic archives and

  14. Stroke: working toward a prioritized world agenda.

    Science.gov (United States)

    Hachinski, Vladimir; Donnan, Geoffrey A; Gorelick, Philip B; Hacke, Werner; Cramer, Steven C; Kaste, Markku; Fisher, Marc; Brainin, Michael; Buchan, Alastair M; Lo, Eng H; Skolnick, Brett E; Furie, Karen L; Hankey, Graeme J; Kivipelto, Miia; Morris, John; Rothwell, Peter M; Sacco, Ralph L; Smith, Sidney C; Wang, Yulun; Bryer, Alan; Ford, Gary A; Iadecola, Costantino; Martins, Sheila C O; Saver, Jeff; Skvortsova, Veronika; Bayley, Mark; Bednar, Martin M; Duncan, Pamela; Enney, Lori; Finklestein, Seth; Jones, Theresa A; Kalra, Lalit; Kleim, Jeff; Nitkin, Ralph; Teasell, Robert; Weiller, Cornelius; Desai, Bhupat; Goldberg, Mark P; Heiss, Wolf-Dieter; Saarelma, Osmo; Schwamm, Lee H; Shinohara, Yukito; Trivedi, Bhargava; Wahlgren, Nils; Wong, Lawrence K; Hakim, Antoine; Norrving, Bo; Prudhomme, Stephen; Bornstein, Natan M; Davis, Stephen M; Goldstein, Larry B; Leys, Didier; Tuomilehto, Jaakko

    2010-08-01

    The aim of the Synergium was to devise and prioritize new ways of accelerating progress in reducing the risks, effects, and consequences of stroke. Preliminary work was performed by seven working groups of stroke leaders followed by a synergium (a forum for working synergistically together) with approximately 100 additional participants. The resulting draft document had further input from contributors outside the synergium. Recommendations of the Synergium are: Basic Science, Drug Development and Technology: There is a need to develop: (1) New systems of working together to break down the prevalent 'silo' mentality; (2) New models of vertically integrated basic, clinical, and epidemiological disciplines; and (3) Efficient methods of identifying other relevant areas of science. Stroke Prevention: (1) Establish a global chronic disease prevention initiative with stroke as a major focus. (2) Recognize not only abrupt clinical stroke, but subtle subclinical stroke, the commonest type of cerebrovascular disease, leading to impairments of executive function. (3) Develop, implement and evaluate a population approach for stroke prevention. (4) Develop public health communication strategies using traditional and novel (eg, social media/marketing) techniques. Acute Stroke Management: Continue the establishment of stroke centers, stroke units, regional systems of emergency stroke care and telestroke networks. Brain Recovery and Rehabilitation: (1) Translate best neuroscience, including animal and human studies, into poststroke recovery research and clinical care. (2) Standardize poststroke rehabilitation based on best evidence. (3) Develop consensus on, then implementation of, standardized clinical and surrogate assessments. (4) Carry out rigorous clinical research to advance stroke recovery. Into the 21st Century: Web, Technology and Communications: (1) Work toward global unrestricted access to stroke-related information. (2) Build centralized electronic archives and

  15. Disease candidate gene identification and prioritization using protein interaction networks

    Directory of Open Access Journals (Sweden)

    Aronow Bruce J

    2009-02-01

    Full Text Available Abstract Background Although most of the current disease candidate gene identification and prioritization methods depend on functional annotations, the coverage of the gene functional annotations is a limiting factor. In the current study, we describe a candidate gene prioritization method that is entirely based on protein-protein interaction network (PPIN analyses. Results For the first time, extended versions of the PageRank and HITS algorithms, and the K-Step Markov method are applied to prioritize disease candidate genes in a training-test schema. Using a list of known disease-related genes from our earlier study as a training set ("seeds", and the rest of the known genes as a test list, we perform large-scale cross validation to rank the candidate genes and also evaluate and compare the performance of our approach. Under appropriate settings – for example, a back probability of 0.3 for PageRank with Priors and HITS with Priors, and step size 6 for K-Step Markov method – the three methods achieved a comparable AUC value, suggesting a similar performance. Conclusion Even though network-based methods are generally not as effective as integrated functional annotation-based methods for disease candidate gene prioritization, in a one-to-one comparison, PPIN-based candidate gene prioritization performs better than all other gene features or annotations. Additionally, we demonstrate that methods used for studying both social and Web networks can be successfully used for disease candidate gene prioritization.

  16. A large-scale benchmark of gene prioritization methods.

    Science.gov (United States)

    Guala, Dimitri; Sonnhammer, Erik L L

    2017-04-21

    In order to maximize the use of results from high-throughput experimental studies, e.g. GWAS, for identification and diagnostics of new disease-associated genes, it is important to have properly analyzed and benchmarked gene prioritization tools. While prospective benchmarks are underpowered to provide statistically significant results in their attempt to differentiate the performance of gene prioritization tools, a strategy for retrospective benchmarking has been missing, and new tools usually only provide internal validations. The Gene Ontology(GO) contains genes clustered around annotation terms. This intrinsic property of GO can be utilized in construction of robust benchmarks, objective to the problem domain. We demonstrate how this can be achieved for network-based gene prioritization tools, utilizing the FunCoup network. We use cross-validation and a set of appropriate performance measures to compare state-of-the-art gene prioritization algorithms: three based on network diffusion, NetRank and two implementations of Random Walk with Restart, and MaxLink that utilizes network neighborhood. Our benchmark suite provides a systematic and objective way to compare the multitude of available and future gene prioritization tools, enabling researchers to select the best gene prioritization tool for the task at hand, and helping to guide the development of more accurate methods.

  17. Women and HIV

    Science.gov (United States)

    ... Consumer Information by Audience For Women Women and HIV: Get the Facts on HIV Testing, Prevention, and Treatment Share Tweet Linkedin Pin ... How can you lower your chance of HIV? HIV Quick Facts What is HIV? HIV is the ...

  18. The HIV/AIDS epidemic in Cuba: description and tentative explanation of its low HIV prevalence

    Directory of Open Access Journals (Sweden)

    Clémençon Stéphan

    2007-11-01

    Full Text Available Abstract Background The Cuban HIV/AIDS epidemic has the lowest prevalence rate of the Caribbean region. The objective of this paper is to give an overview of the HIV/AIDS epidemic in Cuba and to explore the reasons for this low prevalence. Methods Data were obtained from the Cuban HIV/AIDS programme established in 1983. This programme has an extensive adult HIV testing policy, including testing of all pregnant women. HIV and AIDS cases have been recorded since 1986. Persons found to be HIV-positive are interviewed on their sexual behaviour and partners. Tracing and voluntary testing of these partners are organised. Epidemiological description of this epidemic was obtained from analysis of this data set. Using elementary mathematical analyses, we estimated the coverage of the detection system (percentage of HIV-positive adults detected and the average period between HIV infection and detection. Estimated HIV prevalence rates were corrected to account for the coverage. Results HIV prevalence has increased since 1996. In 2005, the prevalence among pregnant women was 1.2 per 10,000 (16/137000. Estimated HIV prevalence among 15- to 49-year-olds was 8.1 per 10,000 (4913/6065000; 95%CI: 7.9 per 10,000 – 8.3 per 10,000. Most (77% of the HIV-positive adults were men, most (85.1% of the detected HIV-positive men were reported as having sex with men (MSM, and most of the HIV-positive women reported having had sex with MSM. The average period between HIV infection and detection was estimated to be 2.1 years (IQR = 1.7 – 2.2 years. We estimated that, for the year 2005, 79.6% (IQR: 77.3 – 81.4% of the HIV-positive persons were detected. Conclusion MSM drive the HIV epidemic in Cuba. The extensive HIV testing policy may be an important factor in explaining the low HIV prevalence. To reduce the HIV epidemic in Cuba, the epidemic among MSM should be addressed. To understand this epidemic further, data on sexual behaviour should be collected. Now that

  19. Use of a quality improvement tool, the prioritization matrix, to identify and prioritize triage software algorithm enhancement.

    Science.gov (United States)

    North, Frederick; Varkey, Prathiba; Caraballo, Pedro; Vsetecka, Darlene; Bartel, Greg

    2007-10-11

    Complex decision support software can require significant effort in maintenance and enhancement. A quality improvement tool, the prioritization matrix, was successfully used to guide software enhancement of algorithms in a symptom assessment call center.

  20. Identifying and prioritizing barriers to implementation of smart energy city projects in Europe: An empirical approach

    International Nuclear Information System (INIS)

    Mosannenzadeh, Farnaz; Di Nucci, Maria Rosaria; Vettorato, Daniele

    2017-01-01

    Successful implementation of smart energy city projects in Europe is crucial for a sustainable transition of urban energy systems and the improvement of quality of life for citizens. We aim to develop a systematic classification and analysis of the barriers hindering successful implementation of smart energy city projects. Through an empirical approach, we investigated 43 communities implementing smart and sustainable energy city projects under the Sixth and Seventh Framework Programmes of the European Union. Validated through literature review, we identified 35 barriers categorized in policy, administrative, legal, financial, market, environmental, technical, social, and information-and-awareness dimensions. We prioritized these barriers, using a novel multi-dimensional methodology that simultaneously analyses barriers based on frequency, level of impact, causal relationship among barriers, origin, and scale. The results indicate that the key barriers are lacking or fragmented political support on the long term at the policy level, and lack of good cooperation and acceptance among project partners, insufficient external financial support, lack of skilled and trained personnel, and fragmented ownership at the project level. The outcome of the research should aid policy-makers to better understand and prioritize implementation barriers to develop effective action and policy interventions towards more successful implementation of smart energy city projects. - Highlights: • A solid empirical study on the implementation of European smart energy city projects. • We found 35 barriers in nine dimensions; e.g. policy, legal, financial, and social. • We suggested a new multi-dimensional methodology to prioritize barriers. • Lacking or fragmented political support on the long term is a key barrier. • We provided insights for action for project coordinators and policy makers.

  1. Target prioritization and strategy selection for active case-finding of pulmonary tuberculosis: a tool to support country-level project planning.

    Science.gov (United States)

    Nishikiori, Nobuyuki; Van Weezenbeek, Catharina

    2013-02-02

    Despite the progress made in the past decade, tuberculosis (TB) control still faces significant challenges. In many countries with declining TB incidence, the disease tends to concentrate in vulnerable populations that often have limited access to health care. In light of the limitations of the current case-finding approach and the global urgency to improve case detection, active case-finding (ACF) has been suggested as an important complementary strategy to accelerate tuberculosis control especially among high-risk populations. The present exercise aims to develop a model that can be used for county-level project planning. A simple deterministic model was developed to calculate the number of estimated TB cases diagnosed and the associated costs of diagnosis. The model was designed to compare cost-effectiveness parameters, such as the cost per case detected, for different diagnostic algorithms when they are applied to different risk populations. The model was transformed into a web-based tool that can support national TB programmes and civil society partners in designing ACF activities. According to the model output, tuberculosis active case-finding can be a costly endeavor, depending on the target population and the diagnostic strategy. The analysis suggests the following: (1) Active case-finding activities are cost-effective only if the tuberculosis prevalence among the target population is high. (2) Extensive diagnostic methods (e.g. X-ray screening for the entire group, use of sputum culture or molecular diagnostics) can be applied only to very high-risk groups such as TB contacts, prisoners or people living with human immunodeficiency virus (HIV) infection. (3) Basic diagnostic approaches such as TB symptom screening are always applicable although the diagnostic yield is very limited. The cost-effectiveness parameter was sensitive to local diagnostic costs and the tuberculosis prevalence of target populations. The prioritization of appropriate target

  2. The Focus on Youth Prevention and Education Research Programme

    Directory of Open Access Journals (Sweden)

    Lynette Deveaux

    2016-10-01

    Full Text Available Like many developing or transitional countries affected by the HIV epidemic, The Bahamas has been deeply committed to HIV and sexually transmitted infection reduction and continues to make great strides in controlling the epidemic within its boundaries. Encouraged by the impact of the Focus on Youth Caribbean (FOYC, a school-based HIV/AIDS prevention programme and its parenting component on Grade 6 and Grade 10 students and their parents, a team of researchers from The Bahamas and the United States sought to implement a similar programme at a national level, while simultaneously evaluating factors that impact the sustainability of sexual risk-reduction programmes like FOYC. This paper describes five research projects conducted in The Bahamas between 1998 and 2016 and includes a list of over 40 published research articles

  3. 76 FR 18399 - Changes To Implement the Prioritized Examination Track (Track I) of the Enhanced Examination...

    Science.gov (United States)

    2011-04-04

    ... prioritized examination fee, processing fee, and publication fee. Therefore, the fee amount due on filing for...) the $4,000 prioritized examination fee; (3) the $130 processing fee; and (4) the $300 publication fee...) prioritized examination fee; (3) the $130 processing fee; and (4) the $300 publication fee. Under prioritized...

  4. Preventing Sexual Violence and HIV in Children

    Science.gov (United States)

    Sommarin, Clara; Kilbane, Theresa; Mercy, James A.; Moloney-Kitts, Michele; Ligiero, Daniela P.

    2018-01-01

    Background Evidence linking violence against women and HIV has grown, including on the cycle of violence and the links between violence against children and women. To create an effective response to the HIV epidemic, it is key to prevent sexual violence against children and intimate partner violence (IPV) against adolescent girls. Methods Authors analyzed data from national household surveys on violence against children undertaken by governments in Swaziland, Tanzania, Kenya, and Zimbabwe, with support of the Together for Girls initiative, as well as an analysis of evidence on effective programmes. Results Data show that sexual and physical violence in childhood are linked to negative health outcomes, including increased sexual risk taking (eg, inconsistent condom use and increased number of sexual partners), and that girls begin experiencing IPV (emotional, physical, and sexual) during adolescence. Evidence on effective programmes addressing childhood sexual violence is growing. Key interventions focus on increasing knowledge among children and caregivers by addressing attitudes and practices around violence, including dating relationships. Programmes also seek to build awareness of services available for children who experience violence. Discussion Findings include incorporating attention to children into HIV and violence programmes directed to adults; increased coordination and leveraging of resources between these programmes; test transferability of programmes in low- and middle-income countries; and invest in data collection and robust evaluations of interventions to prevent sexual violence and IPV among children. Conclusions This article contributes to a growing body of evidence on the prevention of sexual violence and HIV in children. PMID:24918598

  5. Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies.

    Science.gov (United States)

    Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H

    2013-01-01

    multitude of factors. Further analyses using a quasi-experimental design would be useful to programme implementers and policy makers as they face decisions regarding which HIV prevention activities to prioritize.

  6. Consequence Prioritization Process for Potential High Consequence Events (HCE)

    Energy Technology Data Exchange (ETDEWEB)

    Freeman, Sarah G. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2016-10-31

    This document describes the process for Consequence Prioritization, the first phase of the Consequence-Driven Cyber-Informed Engineering (CCE) framework. The primary goal of Consequence Prioritization is to identify potential disruptive events that would significantly inhibit an organization’s ability to provide the critical services and functions deemed fundamental to their business mission. These disruptive events, defined as High Consequence Events (HCE), include both events that have occurred or could be realized through an attack of critical infrastructure owner assets. While other efforts have been initiated to identify and mitigate disruptive events at the national security level, such as Presidential Policy Directive 41 (PPD-41), this process is intended to be used by individual organizations to evaluate events that fall below the threshold for a national security. Described another way, Consequence Prioritization considers threats greater than those addressable by standard cyber-hygiene and includes the consideration of events that go beyond a traditional continuity of operations (COOP) perspective. Finally, Consequence Prioritization is most successful when organizations adopt a multi-disciplinary approach, engaging both cyber security and engineering expertise, as in-depth engineering perspectives are required to recognize and characterize and mitigate HCEs. Figure 1 provides a high-level overview of the prioritization process.

  7. National programme: Finland

    International Nuclear Information System (INIS)

    Forsten, J.

    1986-01-01

    Finland's programmes in the field of reactor pressure components are presented in this paper. The following information on each of these programmes is given: the brief description of the programme; the programme's schedule and duration; the name of the project manager

  8. EPIDEMIOLOGY OF HIV/AIDS IN SOUTH AFRICA

    African Journals Online (AJOL)

    women attending antenatal clinics in 1998 and 1999. ... The Joint United ations Programme on HIV/ AIDS (UNAIDS) and the World Health Organisation (WHO) ... S of every 10 women, and 9 of every 10 children) live in sub-Saharan Africa.

  9. Food insecurity among students living with HIV: Strengthening safety ...

    African Journals Online (AJOL)

    Food insecurity among students living with HIV: Strengthening safety nets at the Nelson Mandela Metropolitan University, South Africa. ... of age and managed as part of the Campus Health Service antiretroviral therapy (ART) programme.

  10. Exploring Opportunities for Mainstreaming HIV/AIDS in the ...

    African Journals Online (AJOL)

    that this programme was mainly meant to spread messages of HIV/AIDS ... communication skills, responsible decision-making, and assertiveness; and it should ... of responsible citizenship and in nurturing creative and emotional development.

  11. Sociodemographic Differences in Access to Care Among Hispanic Patients Who Are HIV Infected in the United States

    Science.gov (United States)

    Morales, Leo S.; Cunningham, William E.; Galvan, Frank H.; Andersen, Ronald M.; Nakazono, Terry T.; Shapiro, Martin F.

    2004-01-01

    This study evaluated associations between sociodemographic factors and access to care, use of highly active antiretroviral therapy, and patients’ ratings of care among Hispanic patients who are HIV infected; we used data from the HIV Cost and Services Utilization Study. Gender, insurance, mode of exposure, and geographic region were associated with access to medical care. Researchers and policymakers should consider sociodemographic factors among Hispanic patients who are HIV positive when designing and prioritizing interventions to improve access to care. PMID:15226129

  12. Scientists’ Prioritization of Communication Objectives for Public Engagement

    Science.gov (United States)

    2016-01-01

    Amid calls from scientific leaders for their colleagues to become more effective public communicators, this study examines the objectives that scientists’ report drive their public engagement behaviors. We explore how scientists evaluate five specific communication objectives, which include informing the public about science, exciting the public about science, strengthening the public’s trust in science, tailoring messages about science, and defending science from misinformation. We use insights from extant research, the theory of planned behavior, and procedural justice theory to identify likely predictors of scientists' views about these communication objectives. Results show that scientists most prioritize communication designed to defend science from misinformation and educate the public about science, and least prioritize communication that seeks to build trust and establish resonance with the public. Regression analyses reveal factors associated with scientists who prioritize each of the five specific communication objectives. Our findings highlight the need for communication trainers to help scientists select specific communication objectives for particular contexts and audiences. PMID:26913869

  13. Prioritizing Information during Working Memory: Beyond Sustained Internal Attention.

    Science.gov (United States)

    Myers, Nicholas E; Stokes, Mark G; Nobre, Anna C

    2017-06-01

    Working memory (WM) has limited capacity. This leaves attention with the important role of allowing into storage only the most relevant information. It is increasingly evident that attention is equally crucial for prioritizing representations within WM as the importance of individual items changes. Retrospective prioritization has been proposed to result from a focus of internal attention highlighting one of several representations. Here, we suggest an updated model, in which prioritization acts in multiple steps: first orienting towards and selecting a memory, and then reconfiguring its representational state in the service of upcoming task demands. Reconfiguration sets up an optimized perception-action mapping, obviating the need for sustained attention. This view is consistent with recent literature, makes testable predictions, and links WM with task switching and action preparation. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Scientists' Prioritization of Communication Objectives for Public Engagement.

    Directory of Open Access Journals (Sweden)

    Anthony Dudo

    Full Text Available Amid calls from scientific leaders for their colleagues to become more effective public communicators, this study examines the objectives that scientists' report drive their public engagement behaviors. We explore how scientists evaluate five specific communication objectives, which include informing the public about science, exciting the public about science, strengthening the public's trust in science, tailoring messages about science, and defending science from misinformation. We use insights from extant research, the theory of planned behavior, and procedural justice theory to identify likely predictors of scientists' views about these communication objectives. Results show that scientists most prioritize communication designed to defend science from misinformation and educate the public about science, and least prioritize communication that seeks to build trust and establish resonance with the public. Regression analyses reveal factors associated with scientists who prioritize each of the five specific communication objectives. Our findings highlight the need for communication trainers to help scientists select specific communication objectives for particular contexts and audiences.

  15. Prioritizing veterinary pharmaceuticals for aquatic environment in Korea.

    Science.gov (United States)

    Kim, Younghee; Jung, Jinyong; Kim, Myunghyun; Park, Jeongim; Boxall, Alistair B A; Choi, Kyungho

    2008-09-01

    Pharmaceutical residues may have serious impacts on nontarget biological organisms in aquatic ecosystems, and have therefore precipitated numerous investigations worldwide. Many pharmaceutical compounds available on the market need to be prioritized based on their potential ecological and human health risks in order to develop sound management decisions. We prioritized veterinary pharmaceuticals in Korea by their usage, potential to enter the environment, and toxicological hazard. Twenty compounds were identified in the top priority class, most of which were antibiotics. Among these compounds, 8 were identified as deserving more immediate attention: amoxicillin, enramycin, fenbendazole, florfenicol, ivermectin, oxytetracycline, tylosin, and virginiamycin. A limitation of this study is that we initially screened veterinary pharmaceuticals by sales tonnage for veterinary use only. However, this is the first attempt to prioritize veterinary pharmaceuticals in Korea, and it provides important concepts for developing environmental risk management plans for such contaminants in aquatic systems. Copyright © 2008 Elsevier B.V. All rights reserved.

  16. Prioritizing Positivity: An Effective Approach to Pursuing Happiness?

    Science.gov (United States)

    Catalino, Lahnna I.; Algoe, Sara B.; Fredrickson, Barbara L.

    2017-01-01

    A decade of research reveals the benefits of positive emotions for mental and physical health; however, recent empirical work suggests the explicit pursuit of happiness may backfire. The present study hypothesized that the pursuit of happiness is not inherently self-defeating; in particular, individuals who seek positivity, as exemplified by how they make decisions about how to organize their day-to-day lives, may be happier. This individual difference is labeled prioritizing positivity. In a community sample of young to older adults (N = 233), prioritizing positivity predicted a host of well-being outcomes (positive emotions, depressive symptomology). In addition, people high in prioritizing positivity have greater resources, and these links are explained by more frequent experiences of positive emotions. In sum, the present study suggests that seeking happiness, although a delicate art, may be a worthwhile pursuit. PMID:25401290

  17. Hanford Mission Plan risk-based prioritization methodologies

    International Nuclear Information System (INIS)

    Hesser, W.A.; Madden, M.S.; Pyron, N.M.; Butcher, J.L.

    1994-08-01

    Sites across the US Department (DOE) complex recognize the critical need for a systematic method for prioritizing among their work scope activities. Here at the Hanford Site, Pacific Northwest Laboratory and Westinghouse Hanford Company (WHC) conducted preliminary research into techniques to meet this need and assist managers in making financial resource allocation decisions. This research is a subtask of the risk management task of the Hanford Mission Plan as described in the WHC Integrated Planning Work Breakdown Structure 1.8.2 Fiscal Year 1994 Work Plan. The research team investigated prioritization techniques used at other DOE sites and compared them with the Priority Planning Grid (PPG), a tool used at Hanford. The authors concluded that the PPG could be used for prioritization of resource allocation, but it needed to be revised to better reflect the Site's priorities and objectives. The revised PPG was tested with three Hanford programs, the PPG was modified, and updated procedures were prepared

  18. Throughput centered prioritization of machines in transfer lines

    International Nuclear Information System (INIS)

    Pascual, R.; Godoy, D.; Louit, D.M.

    2011-01-01

    In an environment of scarce resources and complex production systems, prioritizing is key to confront the challenge of managing physical assets. In the literature, there exist a number of techniques to prioritize maintenance decisions that consider safety, technical and business perspectives. However, the effect of risk mitigating elements-such as intermediate buffers in production lines-on prioritization has not yet been investigated in depth. In this line, the work proposes a user-friendly graphical technique called the system efficiency influence diagram (SEID). Asset managers may use SEID to identify machines that have a greater impact on the system throughput, and thus set prioritized maintenance policies and/or redesign of buffers capacities. The tool provides insight to the analyst as it decomposes the influence of a given machine on the system throughput as a product of two elements: (1) system influence efficiency factor and (2) machine unavailability factor. We illustrate its applicability using three case studies: a four-machine transfer line, a vehicle assembly line, and an open-pit mining conveyor system. The results confirm that the machines with greater unavailability factors are not necessarily the most important for the efficiency of the production line, as it is the case when no intermediate buffers exist. As a decision aid tool, SEID emphasizes the need to move from a maintenance vision focused on machine availability, to a systems engineering perspective. - Highlights: → We propose a graphical technique to prioritize machines in production lines. → The tool is called 'system efficiency influence diagram' (SEID). → It helps setting prioritized maintenance policies and/or redesign of buffers. → The SEID technique focuses on system efficiency and throughput. → We illustrate its applicability using three case studies.

  19. Throughput centered prioritization of machines in transfer lines

    Energy Technology Data Exchange (ETDEWEB)

    Pascual, R., E-mail: rpascual@ing.puc.cl [Physical Asset Management Lab, Centro de Mineria, Pontificia Universidad Catolica de Chile, Av. Vicuna Mackenna 4860, Santiago (Chile); Godoy, D. [Physical Asset Management Lab, Centro de Mineria, Pontificia Universidad Catolica de Chile, Av. Vicuna Mackenna 4860, Santiago (Chile); Louit, D.M. [Komatsu Chile S.A., Av. Americo Vespucio 0631, Quilicura, Santiago (Chile)

    2011-10-15

    In an environment of scarce resources and complex production systems, prioritizing is key to confront the challenge of managing physical assets. In the literature, there exist a number of techniques to prioritize maintenance decisions that consider safety, technical and business perspectives. However, the effect of risk mitigating elements-such as intermediate buffers in production lines-on prioritization has not yet been investigated in depth. In this line, the work proposes a user-friendly graphical technique called the system efficiency influence diagram (SEID). Asset managers may use SEID to identify machines that have a greater impact on the system throughput, and thus set prioritized maintenance policies and/or redesign of buffers capacities. The tool provides insight to the analyst as it decomposes the influence of a given machine on the system throughput as a product of two elements: (1) system influence efficiency factor and (2) machine unavailability factor. We illustrate its applicability using three case studies: a four-machine transfer line, a vehicle assembly line, and an open-pit mining conveyor system. The results confirm that the machines with greater unavailability factors are not necessarily the most important for the efficiency of the production line, as it is the case when no intermediate buffers exist. As a decision aid tool, SEID emphasizes the need to move from a maintenance vision focused on machine availability, to a systems engineering perspective. - Highlights: > We propose a graphical technique to prioritize machines in production lines. > The tool is called 'system efficiency influence diagram' (SEID). > It helps setting prioritized maintenance policies and/or redesign of buffers. > The SEID technique focuses on system efficiency and throughput. > We illustrate its applicability using three case studies.

  20. Predictors of HIV/AIDS confirmation and differences by guardian status in HIV+ adolescents in Jamaica.

    Science.gov (United States)

    Pilgrim, N; Kershaw, T; Pierre, R B; Moore, J; Palmer, P; Davis, D; Christie, C D C

    2008-06-01

    Approximately 25% of the cumulative AIDS cases in Jamaica involve adolescents and young adults. However the lives of adolescents living with HIV within Jamaica and the Caribbean have been understudied. (1) To describe the sociodemographic characteristics of HIV+ Jamaican adolescents who have ever been a part of the Kingston Paediatric/Perinatal HIV Programme (KPAIDS) from September 1, 2002 to August 31, 2006 (2). To identify predictors of HIV/AIDS confirmation as well as factors associated or uniquely present in these adolescents by their guardian status. Seventy-two HIV+ adolescents, ages 10-19 years, were included. Factors studied included demographics as well as time to and time between HIV and AIDS confirmation. Data were analyzed by bivariate and multivariate statistics. The mean age of the adolescents was 12.6 +/- 2.8 years with slightly more males (52.8%) in the programme. There were equal proportions of adolescents living with HIV as with AIDS (43.1%). There were equal proportions who were lost to follow-up or deceased (8.3%). Twenty-two of them lived with parents, 25 with guardians and 18 in residential institutions. The primary mode of transmission was perinatal infection (68.1%), followed by sexual (20.8%), blood transfusion (2.9%) and unknown (8.3%). The mean time from HIV exposure to HIV confirmation and AIDS confirmation in mother-to-child transmission (MTCT) cases were 8.0 +/- 2.9 years and 9.6 +/- 3.3 years, respectively. In the multivariate analysis model, age and gender were significant in predicting time from HIV exposure to HIV confirmation. The majority of HIV-positive adolescents reside with parents and guardians and this might indicate support in spite of stigma and discrimination. However; the mean time to HIV confirmation in MTCT cases is quite long and must be reduced.

  1. Pulmonary candidiasis and CD4 count in HIV positive patients seen ...

    African Journals Online (AJOL)

    Pulmonary candidiasis and CD4 count in HIV positive patients seen in Jos, north central Nigeria. YJ Peter, AH Isa, AS Anzaku, MI Builders. Abstract. Background: Accurate and reliable diagnosis of HIV opportunistic infections plays a central role in effective HIV intervention programmes. Pulmonary infections are the leading ...

  2. The challenge of defining standards of prevention in HIV prevention trials

    NARCIS (Netherlands)

    Philpott, Sean; Heise, Lori; McGrory, Elizabeth; Paxton, Lynn; Hankins, Catherine; Alexander, Lorraine; Apuuli, David Kihumuro; Baeten, Jared; Birx, Deborah; de Bruyn, Guy; Bukusi, Elizabeth; Burns, David; Calazans, Gabriela; Campbell, James; Caswell, Georgina; Coutinho, Alex; Dawson, Liza; Dhai, Amaboo; Dube, Samukeliso; Ecuru, Julius; Essack, Zaynab; Farley, Timothy; Gafos, Mitzy; Irungu, Pauline; Kaleebu, Pontiano; Kamali, Anatoli; Kestelyn, Evelyne; Kublin, James; Lohse, Nicolai; Lutalo, Tom; Macklin, Ruth; Mâsse, Benôıt; Mauney, Chris; McCormack, Sheena; Miller, Lori; Mfutso-Bengo, Joseph; Misra, Rajender; Muganwa, Margaret; Ndase, Patrick; Nel, Annalene; Nielsen, Leslie; Nkala, Busisiwe; O'Reilly, Kevin; Okware, Sam; Paicheler, Geneviève; Rees, Helen; Rerks-Ngarm, Supachai; Ridzon, Renee; Rosenberg, Zeda; Singh, Jerome

    2011-01-01

    As new HIV prevention tools are developed, researchers face a number of ethical and logistic questions about how and when to include novel HIV prevention strategies and tools in the standard prevention package of ongoing and future HIV prevention trials. Current Joint United Nations Programme on

  3. A Controlled Study of an HIV/AIDS/STI/TB Intervention with Faith ...

    African Journals Online (AJOL)

    The aim of the study was to develop an HIV and AIDS training manual, and to evaluate the knowledge, attitudes and management of faith healers of Apostolic churches regarding HIV and AIDS, before and after they attended an HIV and AIDS training programme. A quasi-experimental intervention design was used with faith ...

  4. Spécialiste de programmes principal (h/f) | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... le Gestionnaire de programme (GP) si applicable, et le Directeur de domaine de ... jouer le rôle de premier plan, dans le contexte d'un portefeuille de projets de ... définition et à l'évaluation de tendances clés et de priorités émergentes dans ...

  5. Prevention of Mother-to-Child Transmission of HIV data ...

    African Journals Online (AJOL)

    2014-08-21

    Aug 21, 2014 ... service delivery in the public health sector of South Africa .... professional nurse in charge of the PMTCT programme at ... 1. antenatal care (ANC) clients pre-test counselled for HIV ..... CD4, Cluster of differentiation; NVP, Nevirapine; PMTCT, prevention of mother-to-child transmission of HIV; DHIS, District.

  6. Older people living with HIV in Uganda: understanding their ...

    African Journals Online (AJOL)

    HIV-prevention, treatment and care programmes should seek to meet the special needs of older people through focused and innovative approaches. Further research with larger samples is needed to explore the impact of these healthcare needs on the quality of life of older people living with HIV. Keywords: ageing ...

  7. Reproductive decisions of couples living with HIV in Malawi: What ...

    African Journals Online (AJOL)

    policies and guidelines on HIV, AIDS and sexual and reproductive health in Malawi for ... reflect the social cultural experiences of couples living with HIV. In addition, there is ... then, treatment is available free of charge in the public hospital facilities. ... started implementing an integrated antiretroviral / PMTCT programme ...

  8. Sexual Dysfunction among HIV Patients: Three Case Reports and ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    However SRHR policies, strategic plans and programmes ... changes in sexual behaviour with increased knowledge ... intercourse remains the main mode of HIV .... country, married to a 34 year old travel agent with .... as the treatment of choice for ED in HIV-infected ..... image: A handbook of theory, research, and clinical.

  9. Communication context of Roll Back Malaria and HIV and AIDS ...

    African Journals Online (AJOL)

    With malaria endemic and HIV and AIDS transmuting into a pandemic, the disease burden posed by the two have made them the focus of national and global attention. This necessitated a comparative scrutiny of the communication component of the Roll Back Malaria and HIV and AIDS programmes in Nigeria; and the ...

  10. Enhancing HIV status disclosure and partners' testing through ...

    African Journals Online (AJOL)

    Background: In Tanzania HIV Testing and Counselling (HTC) is being implemented through voluntary counselling and testing (VCT), provider initiated counselling and testing (PITC) and work place counselling and testing (HTC). Within these programmes, HIV status disclosure is emphasized. However, among persons who ...

  11. Five Myths about the HIV Epidemic in Asia

    OpenAIRE

    Godwin, Peter; O'Farrell, Nigel; Fylkesnes, Knut; Misra, Sujaya

    2006-01-01

    It is widely recognised that the huge population sizes of many Asian countries mean that although national HIV prevalence levels are still very low, very large absolute numbers of people are being infected each year with HIV [1]. Urgent responses are required; the effective responses by countries such as Thailand and Cambodia have shown how much can be done. As implementers who have worked with HIV/AIDS programmes in several countries in the region, we recognise the public health and welf...

  12. Monitoring community mobilisation and organisational capacity among high-risk groups in a large-scale HIV prevention programme in India: selected findings using a Community Ownership and Preparedness Index.

    Science.gov (United States)

    Narayanan, Pradeep; Moulasha, K; Wheeler, Tisha; Baer, James; Bharadwaj, Sowmyaa; Ramanathan, T V; Thomas, Tom

    2012-10-01

    In a participatory approach to health and development interventions, defining and measuring community mobilisation is important, but it is challenging to do this effectively, especially at scale. A cross-sectional, participatory monitoring tool was administered in 2008-2009 and 2009-2010 across a representative sample of 25 community-based groups (CBGs) formed under the Avahan India AIDS Initiative, to assess their progress in mobilisation, and to inform efforts to strengthen the groups and make them sustainable. The survey used a weighted index to capture both qualitative and quantitative data in numeric form. The index permitted broad, as well as highly detailed, analysis of community mobilisation, relevant at the level of individual groups, as well as state-wide and across the whole programme. The survey demonstrated that leadership and programme management were the strongest areas among the CBGs, confirming the programme's investment in these areas. Discussion of the Round 1 results led to efforts to strengthen governance and democratic decision making in the groups, and progress was reflected in the Round 2 survey results. CBG engagement with state authorities to gain rights and entitlements and securing the long-term financial stability of groups remain a challenge. The survey has proven useful for informing the managers of programmes about what is happening on the ground, and it has opened spaces for discussion within community groups about the nature of leadership, decision making and their goals, which is leading to accelerated progress. The tool provided useful data to manage community mobilisation in Avahan.

  13. HIV prevention and low-income Chilean women: machismo, marianismo and HIV misconceptions.

    Science.gov (United States)

    Cianelli, Rosina; Ferrer, Lilian; McElmurry, Beverly J

    2008-04-01

    Socio-cultural factors and HIV-related misinformation contribute to the increasing number of Chilean women living with HIV. In spite of this, and to date, few culturally specific prevention activities have been developed for this population. The goal of the present study was to elicit the perspectives of low-income Chilean women regarding HIV and relevant socio-cultural factors, as a forerunner to the development of a culturally appropriate intervention. As part of a mixed-methods study, fifty low-income Chilean women participated in a survey and twenty were selected to participate in prevention, in-depth interviews. Results show evidence of widespread misinformation and misconceptions related to HIV/AIDS. Machismo and marianismo offer major barriers to prevention programme development. Future HIV prevention should stress partner communication, empowerment and improving the education of women vulnerable to HIV.

  14. Optimizing the Prioritization of Natural Disaster Recovery Projects

    National Research Council Canada - National Science Library

    Aftanas, Jason M

    2007-01-01

    .... This work will focus on promoting objectivity in the project prioritizing process, improving the communication of the overall base recovery requirement, increasing efficiency in utilizing human and monetary resources, and the creation of a usable and repeatable decision-making tool based on Value-Focused Thinking and integer programming methods.

  15. A method for the efficient prioritization of infrastructure renewal projects

    International Nuclear Information System (INIS)

    Karydas, D.M.; Gifun, J.F.

    2006-01-01

    The infrastructure renewal program at MIT consists of a large number of projects with an estimated budget that could approach $1 billion. Infrastructure renewal at the Massachusetts Institute of Technology (MIT) is the process of evaluating and investing in the maintenance of facility systems and basic structure to preserve existing campus buildings. The selection and prioritization of projects must be addressed with a systematic method for the optimal allocation of funds and other resources. This paper presents a case study of a prioritization method utilizing multi-attribute utility theory. This method was developed at MIT's Department of Nuclear Engineering and was deployed by the Department of Facilities after appropriate modifications were implemented to address the idiosyncrasies of infrastructure renewal projects and the competing criteria and constraints that influence the judgment of the decision-makers. Such criteria include minimization of risk, optimization of economic impact, and coordination with academic policies, programs, and operations of the Institute. A brief overview of the method is presented, as well as the results of its application to the prioritization of infrastructure renewal projects. Results of workshops held at MIT with the participation of stakeholders demonstrate the feasibility of the prioritization method and the usefulness of this approach

  16. Prioritizing Training To Maximize Results: The 3 Box System.

    Science.gov (United States)

    Kearns, Paul

    2003-01-01

    Considers fundamentals of effective training and focuses on the evaluation of training. Describes the 3 Box System, which provides a framework for discussing: (1) basic training needs and priorities; (2) added value training, including ROI (return on investment); evaluation; and (3) prioritizing training budgets. (LRW)

  17. Aggressive effects of prioritizing popularity in early adolescence

    NARCIS (Netherlands)

    Cillessen, A.H.N.; Mayeux, L.; Ha, P.T.; Bruyn, E.H. de; LaFontana, K.M.

    2014-01-01

    This study examined the moderating effects of prioritizing popularity on the association between early adolescents' popularity and their aggressive, leadership, and prosocial behaviors with peers. Participants were 288 14-year-olds from The Netherlands who completed a sociometric instrument and an

  18. The noise control prioritizing index in a tire manufacturing company

    Directory of Open Access Journals (Sweden)

    Rostam Golmohammadi

    2017-11-01

    Conclusion; the results of the present study indicated that using an index resulted from a combination of various parameters affecting the noise pollution, we would be able to prioritize units for implementing noise pollution control confidently. The results of the present study are applicable to all similar industrial settings.

  19. Web tools for the prioritization of candidate disease genes.

    NARCIS (Netherlands)

    Oti, M.O.; Ballouz, S.; Wouters, M.A.

    2011-01-01

    Despite increasing sequencing capacity, genetic disease investigation still frequently results in the identification of loci containing multiple candidate disease genes that need to be tested for involvement in the disease. This process can be expedited by prioritizing the candidates prior to

  20. Genomic dissection and prioritizing of candidate genes of QTL for ...

    Indian Academy of Sciences (India)

    Genomic dissection and prioritizing of candidate genes of QTL for regulating spontaneous arthritis on chromosome 1 in mice deficient for interleukin-1 receptor antagonist. Yanhong Cao, Jifei Zhang, Yan Jiao, Jian Yan, Feng Jiao, XiaoYun Liu, Robert W. Williams, Karen A. Hasty,. John M. Stuart and Weikuan Gu. J. Genet.

  1. Sensitivity-based research prioritization through stochastic characterization modeling

    DEFF Research Database (Denmark)

    Wender, Ben A.; Prado-Lopez, Valentina; Fantke, Peter

    2018-01-01

    to guide research efforts in data refinement and design of experiments for existing and emerging chemicals alike. This study presents a sensitivity-based approach for estimating toxicity characterization factors given high input data uncertainty and using the results to prioritize data collection according...

  2. A COMPARISON OF APPROACHES TO PRIORITIZING SITES FOR RIPARIAN RESTORATION

    Science.gov (United States)

    This study compares the results of Olson and Harris (1997) and Russell et al.(1997)in their work to prioritize sites for riparian restoration in the San Luis Rey River watershed. Olson and Harris defined reaches of the mainstem and evaluated the relative potential for restoration...

  3. An expert system for automated flavour matching - Prioritizer

    DEFF Research Database (Denmark)

    Silva, Bárbara Santos; Tøstesen, Marie; Petersen, Mikael Agerlin

    2017-01-01

    Flavour matching can be viewed as trying to reproduce a specific flavour. This is a time consuming task and may lead to flavour mixtures that are too complex or too expensive to be commercialized. In order to facilitate the matching, we have developed a new mathematical model, called Prioritizer....

  4. Prioritizing substitution of organic solvents in industrial cleaning processes

    DEFF Research Database (Denmark)

    Rasmussen, Pia Brunn; Jacobsen, Thomas

    1997-01-01

    A method for prioritizing the substitution of volatile organic compounds (VOC) used in industrial cleaning processes is developed. The result is a matrix, which, if all information can be obtained, gives a comprehensive description of the effects, exposure and emission of VOC, as well as the pros...

  5. The effect of requirements prioritization on avionics system conceptual design

    Science.gov (United States)

    Lorentz, John

    This dissertation will provide a detailed approach and analysis of a new collaborative requirements prioritization methodology that has been used successfully on four Coast Guard avionics acquisition and development programs valued at $400M+. A statistical representation of participant study results will be discussed and analyzed in detail. Many technically compliant projects fail to deliver levels of performance and capability that the customer desires. Some of these systems completely meet "threshold" levels of performance; however, the distribution of resources in the process devoted to the development and management of the requirements does not always represent the voice of the customer. This is especially true for technically complex projects such as modern avionics systems. A simplified facilitated process for prioritization of system requirements will be described. The collaborative prioritization process, and resulting artifacts, aids the systems engineer during early conceptual design. All requirements are not the same in terms of customer priority. While there is a tendency to have many thresholds inside of a system design, there is usually a subset of requirements and system performance that is of the utmost importance to the design. These critical capabilities and critical levels of performance typically represent the reason the system is being built. The systems engineer needs processes to identify these critical capabilities, the associated desired levels of performance, and the risks associated with the specific requirements that define the critical capability. The facilitated prioritization exercise is designed to collaboratively draw out these critical capabilities and levels of performance so they can be emphasized in system design. Developing the purpose, scheduling and process for prioritization events are key elements of systems engineering and modern project management. The benefits of early collaborative prioritization flow throughout the

  6. Ghana's nuclear programme

    International Nuclear Information System (INIS)

    Ahafia, Albert K.

    1988-01-01

    The Paper gives the purpose of Ghana's Nuclear Programme and describes some specific research activities and peaceful applications of atomic energy in agriculture, medicine and industry. A discussion of some of the problem facing the programme concludes the Paper. (author)

  7. improving education programme at pmtct sites in liberia

    African Journals Online (AJOL)

    STIs Control Programme, VOA Robert Field Highway ... was conducted in November 2011 at the John .... whether or not HIV related (Victora et al., 1987) . In ... tages/D isad van tages o f B reastfeed in g an d th e. R ep lacemen t Feed in g A.

  8. Workplace ART programmes: Why do companies invest in them and ...

    African Journals Online (AJOL)

    Prevalence data indicates that certain sectors within the private sector are particularly affected by HIV/AIDS. Companies in southern Africa began implementing treatment programmes in early 2002 as the corporate sector came to realise the financial imperative of offsetting employee morbidity and mortality. This article sets ...

  9. HIV Prevention

    Centers for Disease Control (CDC) Podcasts

    2012-02-01

    Dr. Kevin Fenton, Director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, talks about steps people can take to protect their health from HIV.  Created: 2/1/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 2/1/2012.

  10. The Winfrith DSN programme

    International Nuclear Information System (INIS)

    Francescon, S.

    1963-05-01

    The programme, which is written in the Fortran language, solves the Carlson discrete S n approximation to the Boltzmann transport equation in cylindrical geometry. This report describes the input and output facilities of the WINFRITH DSN programme and the associated editing programme WED. (author)

  11. The Winfrith DSN programme

    Energy Technology Data Exchange (ETDEWEB)

    Francescon, S [General Reactor Physics Division, Atomic Energy Establishment, Winfrith, Dorchester, Dorset (United Kingdom)

    1963-05-15

    The programme, which is written in the Fortran language, solves the Carlson discrete S{sub n} approximation to the Boltzmann transport equation in cylindrical geometry. This report describes the input and output facilities of the WINFRITH DSN programme and the associated editing programme WED. (author)

  12. UNESCO's Ethics Education Programme.

    NARCIS (Netherlands)

    Have, H.A.M.J. ten

    2008-01-01

    Unesco initiated the Ethics Education Programme in 2004 at the request of member states to reinforce and increase the capacities in the area of ethics teaching. The programme is focused on providing detailed information about existing teaching programmes. It also develops and promotes teaching

  13. Prioritizing Chemicals for Risk Assessment Using Chemoinformatics: Examples from the IARC Monographs on Pesticides.

    Science.gov (United States)

    Guha, Neela; Guyton, Kathryn Z; Loomis, Dana; Barupal, Dinesh Kumar

    2016-12-01

    Identifying cancer hazards is the first step towards cancer prevention. The International Agency for Research on Cancer (IARC) Monographs Programme, which has evaluated nearly 1,000 agents for their carcinogenic potential since 1971, typically selects agents for hazard identification on the basis of public nominations, expert advice, published data on carcinogenicity, and public health importance. Here, we present a novel and complementary strategy for identifying agents for hazard evaluation using chemoinformatics, database integration, and automated text mining. To inform selection among a broad range of pesticides nominated for evaluation, we identified and screened nearly 6,000 relevant chemical structures, after which we systematically compiled information on 980 pesticides, creating network maps that allowed cluster visualization by chemical similarity, pesticide class, and publicly available information concerning cancer epidemiology, cancer bioassays, and carcinogenic mechanisms. For the IARC Monograph meetings that took place in March and June 2015, this approach supported high-priority evaluation of glyphosate, malathion, parathion, tetrachlorvinphos, diazinon, p,p'-dichlorodiphenyltrichloroethane (DDT), lindane, and 2,4-dichlorophenoxyacetic acid (2,4-D). This systematic approach, accounting for chemical similarity and overlaying multiple data sources, can be used by risk assessors as well as by researchers to systematize, inform, and increase efficiency in selecting and prioritizing agents for hazard identification, risk assessment, regulation, or further investigation. This approach could be extended to an array of outcomes and agents, including occupational carcinogens, drugs, and foods. Citation: Guha N, Guyton KZ, Loomis D, Barupal DK. 2016. Prioritizing chemicals for risk assessment using chemoinformatics: examples from the IARC Monographs on Pesticides. Environ Health Perspect 124:1823-1829; http://dx.doi.org/10.1289/EHP186.

  14. Prioritizing Chemicals for Risk Assessment Using Chemoinformatics: Examples from the IARC Monographs on Pesticides

    Science.gov (United States)

    Guha, Neela; Guyton, Kathryn Z.; Loomis, Dana; Barupal, Dinesh Kumar

    2016-01-01

    Background: Identifying cancer hazards is the first step towards cancer prevention. The International Agency for Research on Cancer (IARC) Monographs Programme, which has evaluated nearly 1,000 agents for their carcinogenic potential since 1971, typically selects agents for hazard identification on the basis of public nominations, expert advice, published data on carcinogenicity, and public health importance. Objectives: Here, we present a novel and complementary strategy for identifying agents for hazard evaluation using chemoinformatics, database integration, and automated text mining. Discussion: To inform selection among a broad range of pesticides nominated for evaluation, we identified and screened nearly 6,000 relevant chemical structures, after which we systematically compiled information on 980 pesticides, creating network maps that allowed cluster visualization by chemical similarity, pesticide class, and publicly available information concerning cancer epidemiology, cancer bioassays, and carcinogenic mechanisms. For the IARC Monograph meetings that took place in March and June 2015, this approach supported high-priority evaluation of glyphosate, malathion, parathion, tetrachlorvinphos, diazinon, p,p′-dichlorodiphenyltrichloroethane (DDT), lindane, and 2,4-dichlorophenoxyacetic acid (2,4-D). Conclusions: This systematic approach, accounting for chemical similarity and overlaying multiple data sources, can be used by risk assessors as well as by researchers to systematize, inform, and increase efficiency in selecting and prioritizing agents for hazard identification, risk assessment, regulation, or further investigation. This approach could be extended to an array of outcomes and agents, including occupational carcinogens, drugs, and foods. Citation: Guha N, Guyton KZ, Loomis D, Barupal DK. 2016. Prioritizing chemicals for risk assessment using chemoinformatics: examples from the IARC Monographs on Pesticides. Environ Health Perspect 124:1823–1829;

  15. Building partnerships to address the HIV epidemic.

    Science.gov (United States)

    Chua, A C; Leo, Y S; Lee, C C

    2008-05-01

    Batam is one of the islands comprising the Riau Province in Indonesia, and is closest to Singapore. It is a popular destination of many Singaporeans. Surveillance reports among commercial sex workers conducted in Batam showed the prevalence rate of human immunodeficiency virus (HIV) is 16.2 percent. At the end of 2006, the total number of HIV-infected Singaporeans was 3,060, the majority being infected via heterosexual transmission. The aim of the Indonesian government is to rapidly scale up HIV treatment to those needing it. One of the factors critical to the rapid scale-up is healthcare worker training. An intersectoral collaboration addressing the issue of HIV care and treatment with a hospital in Batam was created. The first activity of the collaboration was a two-day HIV training course conducted in February 2007. The aim of the course was to provide a basic understanding of HIV, as well as knowledge on common opportunistic infections that may present to a general hospital or clinical setting. 34 doctors from 23 institutions in Batam and three doctors from two hospitals in the Riau Islands attended the two-day HIV training course. The participants found the training very useful and highly relevant. This first HIV training provided a foundation to build on further HIV education. It is our belief that through the HIV training programme, there will be more awareness of HIV among the various medical institutions in Batam. As the HIV epidemic knows no borders, working with neighbouring countries is one strategy that deserves attention.

  16. Efficient population-scale variant analysis and prioritization with VAPr.

    Science.gov (United States)

    Birmingham, Amanda; Mark, Adam M; Mazzaferro, Carlo; Xu, Guorong; Fisch, Kathleen M

    2018-04-06

    With the growing availability of population-scale whole-exome and whole-genome sequencing, demand for reproducible, scalable variant analysis has spread within genomic research communities. To address this need, we introduce the Python package VAPr (Variant Analysis and Prioritization). VAPr leverages existing annotation tools ANNOVAR and MyVariant.info with MongoDB-based flexible storage and filtering functionality. It offers biologists and bioinformatics generalists easy-to-use and scalable analysis and prioritization of genomic variants from large cohort studies. VAPr is developed in Python and is available for free use and extension under the MIT License. An install package is available on PyPi at https://pypi.python.org/pypi/VAPr, while source code and extensive documentation are on GitHub at https://github.com/ucsd-ccbb/VAPr. kfisch@ucsd.edu.

  17. A weight restricted DEA model for FMEA risk prioritization

    Directory of Open Access Journals (Sweden)

    Pauli Adriano de Almada Garcia

    2012-01-01

    Full Text Available In this paper we present a linear programming (LP approach to risk prioritization in failure mode and effects analysis (FMEA. The LP is a data envelopment analysis (DEA-based model considering weight restriction. In a FMEA, we commonly consider three criteria to prioritize the failure modes, occurrence, severity and detectability. These criteria are in an ordinal scale commonly varying from 1 to 10, higher the figure worse the result. Considering the values established for each criteria, in traditional FMEA one adopts a Risk Priority Number, calculated considering the product of criteria, which has been very criticized due to its shortcoming. Through the proposed approach a frontier is established considering the less critical failure modes. Considering this frontier, one can establish how much each failure mode must be improved to become relatively acceptable. A simplified case concerning an AFWS of a two loops PWR power plant is presented to shows the applicability of the proposed approach.

  18. Modeling and prioritizing demand response programs in power markets

    International Nuclear Information System (INIS)

    Aalami, H.A.; Moghaddam, M. Parsa; Yousefi, G.R.

    2010-01-01

    One of the responsibilities of power market regulator is setting rules for selecting and prioritizing demand response (DR) programs. There are many different alternatives of DR programs for improving load profile characteristics and achieving customers' satisfaction. Regulator should find the optimal solution which reflects the perspectives of each DR stakeholder. Multi Attribute Decision Making (MADM) is a proper method for handling such optimization problems. In this paper, an extended responsive load economic model is developed. The model is based on price elasticity and customer benefit function. Prioritizing of DR programs can be realized by means of Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) method. Considerations of ISO/utility/customer regarding the weighting of attributes are encountered by entropy method. An Analytical Hierarchy Process (AHP) is used for selecting the most effective DR program. Numerical studies are conducted on the load curve of the Iranian power grid in 2007. (author)

  19. Effects of preference heterogeneity among landowners on spatial conservation prioritization

    DEFF Research Database (Denmark)

    Nielsen, Anne Sofie Elberg; Strange, Niels; Bruun, Hans Henrik

    2017-01-01

    The participation of private landowners in conservation is crucial to efficient biodiversity conservation. This is especially the case in settings where the share of private ownership is large and the economic costs associated with land acquisition are high. We used probit regression analysis...... into a spatial prioritization for conservation of unmanaged forests. The choice models are based on sociodemographic data on the entire population of Danish forest owners and historical data on their participation in conservation schemes. Inclusion in the model of information on private landowners' willingness...... to supply land for conservation yielded at intermediate budget levels up to 30% more expected species coverage than the uninformed prioritization scheme. Our landowner-choice model provides an example of moving toward more implementable conservation planning....

  20. Sustainability Decision Support Framework for Industrial System Prioritization

    DEFF Research Database (Denmark)

    Ren, Jingzheng; Wei, Shunan; Goodsite, Michael Evan

    2016-01-01

    A multicriteria decision-making methodology for the sustainability prioritization of industrial systems is proposed. The methodology incorporates a fuzzy Analytic Hierarchy Process method that allows the users to assess the soft criteria using linguistic terms. A fuzzy Analytic Network Process...... method is used to calculate the weights of each criterion, which can tackle the interdependencies and interactions among the criteria. The Preference Ranking Organization Method for Enrichment Evaluation approach is used to prioritize the sustainability sequence of the alternative systems. Moreover......, a sensitivity analysis method was developed to investigate the most critical and sensitive criteria. The developed methodology was illustrated by a case study to rank the sustainability of five alternative hydrogen production technologies. The advantages of the developed methodology over the previous approaches...

  1. Patient prioritization in medical emergencies: an ethical analysis.

    Science.gov (United States)

    Fortes, Paulo Antônio de Carvalho; Pereira, Patricia Cristina Andrade

    2012-01-01

    To identify and analyze, in the light of ethical considerations, the choices and justifications of public health professionals in hypothetical situations of patient prioritization in circumstances of limited resources during emergency medical care. Qualitative and quantitative study, carried out through interviews with 80 public health professionals, graduate students (MSc and PhD students) in public health who were faced with hypothetical situations involving the criteria of gender, age, and responsibility, asked to choose between alternatives that referred to the existence of people, equally submitted to life-threatening situations, who needed care in an emergency department. The choices prioritized children, young individuals, women, and married women, with decision-making invoking the ethical principles of vulnerability, social utility, and equity. The study shows a clear tendency to justify the choices that were made, guided by utilitarian ethics.

  2. Points to consider for prioritizing clinical genetic testing services

    DEFF Research Database (Denmark)

    Severin, Franziska; Borry, Pascal; Cornel, Martina C

    2015-01-01

    Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set...... testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit......, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management.European Journal of Human Genetics advance online publication, 24 September 2014; doi:10.1038/ejhg.2014.190....

  3. Healthcare Analytics: Creating a Prioritized Improvement System with Performance Benchmarking.

    Science.gov (United States)

    Kolker, Eugene; Kolker, Evelyne

    2014-03-01

    The importance of healthcare improvement is difficult to overstate. This article describes our collaborative work with experts at Seattle Children's to create a prioritized improvement system using performance benchmarking. We applied analytics and modeling approaches to compare and assess performance metrics derived from U.S. News and World Report benchmarking data. We then compared a wide range of departmental performance metrics, including patient outcomes, structural and process metrics, survival rates, clinical practices, and subspecialist quality. By applying empirically simulated transformations and imputation methods, we built a predictive model that achieves departments' average rank correlation of 0.98 and average score correlation of 0.99. The results are then translated into prioritized departmental and enterprise-wide improvements, following a data to knowledge to outcomes paradigm. These approaches, which translate data into sustainable outcomes, are essential to solving a wide array of healthcare issues, improving patient care, and reducing costs.

  4. Comparison of methods for prioritizing risk in radiation oncology

    International Nuclear Information System (INIS)

    Biazotto, Bruna; Tokarski, Marcio

    2016-01-01

    Proactive risk management tools, such as Failure Mode and Effect Analysis (FEMA), were imported from engineering and have been widely used in Radiation Oncology. An important step in this process is the risk prioritization and there are many methods to do that. This paper compares the risk prioritization of computerized planning phase in interstitial implants with high dose rate brachytherapy performed with Health Care Failure Mode and Effect Analysis (HFMEA) and FMEA with guidelines given by the Task Group 100 (TG 100) of the American Association of Physicists in Medicine. Out of the 33 possible failure modes of this process, 21 require more attention when evaluated by HFMEA and 22, when evaluated by FMEA TG 100. Despite the high coincidence between the methods, the execution of HFMEA was simpler. (author)

  5. 13 CFR 107.1520 - How a Licensee computes and allocates Prioritized Payments to SBA.

    Science.gov (United States)

    2010-01-01

    ... Prioritized Payments, earned Adjustments and earned Charges. (3) Earned Payments Account. The Earned Payments... Distribution: (1) Bring the Accumulation Account up to date by adding to it all Prioritized Payments and... Payments to SBA. This section tells you how to compute Prioritized Payments, Adjustments and Charges on...

  6. Experimentation on accuracy of non functional requirement prioritization approaches for different complexity projects

    OpenAIRE

    Raj Kumar Chopra; Varun Gupta; Durg Singh Chauhan

    2016-01-01

    Non functional requirements must be selected for implementation together with functional requirements to enhance the success of software projects. Three approaches exist for performing the prioritization of non functional requirements using the suitable prioritization technique. This paper performs experimentation on three different complexity versions of the industrial software project using cost-value prioritization technique employing three approaches. Experimentation is conducted to analy...

  7. Consequences for diversity when prioritizing animals for conservation with pedigree or genomic information

    NARCIS (Netherlands)

    Engelsma, K.A.; Veerkamp, R.F.; Calus, M.P.L.; Windig, J.J.

    2011-01-01

    Up to now, prioritization of animals for conservation has been mainly based on pedigree information; however, genomic information may improve prioritization. In this study, we used two Holstein populations to investigate the consequences for genetic diversity when animals are prioritized with

  8. Prioritizing zoonotic diseases in Ethiopia using a one health approach

    Directory of Open Access Journals (Sweden)

    Emily G. Pieracci

    2016-12-01

    Discussion: Multi-sectoral collaborations strengthen disease surveillance system development in humans and animals, enhance laboratory capacity, and support implementation of prevention and control strategies. To facilitate this, the creation of a One Health-focused Zoonotic Disease Unit is recommended. Enhancement of public health and veterinary laboratories, joint outbreak and surveillance activities, and intersectoral linkages created to tackle the prioritized zoonotic diseases will undoubtedly prepare the country to effectively address newly emerging zoonotic diseases.

  9. Place prioritization for biodiversity content using species ecological niche modeling

    OpenAIRE

    Víctor Sánchez-Cordero; Verónica Cirelli; Mariana Munguial; Sahotra Sarkar

    2005-01-01

    Place prioritization for biodiversity representation is essential for conservation planning, particularly in megadiverse countries where high deforestation threatens biodiversity. Given the collecting biases and uneven sampling of biological inventories, there is a need to develop robust models of species’ distributions. By modeling species’ ecological niches using point occurrence data and digitized environmental feature maps, we can predict potential and extant distributions of species in u...

  10. Research gaps in neonatal HIV-related care

    Directory of Open Access Journals (Sweden)

    Mary-Ann Davies

    2015-05-01

    Full Text Available The South African prevention of mother to child transmission programme has made excellentprogress in reducing vertical HIV transmission, and paediatric antiretroviral therapyprogrammes have demonstrated good outcomes with increasing treatment initiation inyounger children and infants. However, both in South Africa and across sub-Saharan African,lack of boosted peri-partum prophylaxis for high-risk vertical transmission, loss to followup,and failure to initiate HIV-infected infants on antiretroviral therapy (ART before diseaseprogression are key remaining gaps in neonatal HIV-related care. In this issue of the Southern African Journal of HIV Medicine, experts provide valuable recommendations for addressingthese gaps. The present article highlights a number of areas where evidence is lacking toinform guidelines and programme development for optimal neonatal HIV-related care.

  11. Prioritizing lean management practices in public and private hospitals.

    Science.gov (United States)

    Hussain, Matloub; Malik, Mohsin

    2016-05-16

    Purpose - The purpose of this paper is to prioritize 21 healthcare wastes in public and private hospitals of United Arab Emirates (UAE). Design/methodology/approach - Seven healthcare wastes linked with lean management are further decomposed in to sub-criteria and to deal with this complexity of multi criteria decision-making process, analytical hierarchical process (AHP) method is used in this research. Findings - AHP framework for this study resulted in a ranking of 21 healthcare wastes in public and private hospitals of UAE. It has been found that management in private healthcare systems of UAE is putting more emphasis on the inventory waste. On the other hand, over processing waste has got highest weight in public hospitals of UAE. Research limitations/implications - The future directions of this research would be to apply a lean set of tools for the value stream optimization of the prioritized key improvement areas. Practical implications - This is a contribution to the continuing research into lean management, giving practitioners and designers a practical way for measuring and implementing lean practices across health organizations. Originality/value - The contribution of this research, through successive stages of data collection, measurement analysis and refinement, is a set of reliable and valid framework that can be subsequently used in conceptualization, prioritization of the waste reduction strategies in healthcare management.

  12. Data integration to prioritize drugs using genomics and curated data.

    Science.gov (United States)

    Louhimo, Riku; Laakso, Marko; Belitskin, Denis; Klefström, Juha; Lehtonen, Rainer; Hautaniemi, Sampsa

    2016-01-01

    Genomic alterations affecting drug target proteins occur in several tumor types and are prime candidates for patient-specific tailored treatments. Increasingly, patients likely to benefit from targeted cancer therapy are selected based on molecular alterations. The selection of a precision therapy benefiting most patients is challenging but can be enhanced with integration of multiple types of molecular data. Data integration approaches for drug prioritization have successfully integrated diverse molecular data but do not take full advantage of existing data and literature. We have built a knowledge-base which connects data from public databases with molecular results from over 2200 tumors, signaling pathways and drug-target databases. Moreover, we have developed a data mining algorithm to effectively utilize this heterogeneous knowledge-base. Our algorithm is designed to facilitate retargeting of existing drugs by stratifying samples and prioritizing drug targets. We analyzed 797 primary tumors from The Cancer Genome Atlas breast and ovarian cancer cohorts using our framework. FGFR, CDK and HER2 inhibitors were prioritized in breast and ovarian data sets. Estrogen receptor positive breast tumors showed potential sensitivity to targeted inhibitors of FGFR due to activation of FGFR3. Our results suggest that computational sample stratification selects potentially sensitive samples for targeted therapies and can aid in precision medicine drug repositioning. Source code is available from http://csblcanges.fimm.fi/GOPredict/.

  13. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008.

    Science.gov (United States)

    Shah, Ira; Lala, Mamatha; Damania, Kaizad

    2017-01-01

    Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother-to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Prevalence of HIV in pregnant women in Mumbai is decreasing.

  14. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

    Directory of Open Access Journals (Sweden)

    Ira Shah

    2017-01-01

    Full Text Available Aim: Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother–to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. Materials and Methods: All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. Results: A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Conclusion: Prevalence of HIV in pregnant women in Mumbai is decreasing.

  15. Prevalence of HIV infection in pregnant women in Mumbai, India: Experience from 1993-2004 and 2008

    Science.gov (United States)

    Shah, Ira; Lala, Mamatha; Damania, Kaizad

    2017-01-01

    Aim: Prevalence of HIV among pregnant women in India is of great concern, especially to prevent HIV in children. Mother–to-child transmission of HIV is the most common cause of transmission of HIV in children. Prevalence of HIV infection in pregnant women in India has ranged from 0.7% to 1.2%. Thus, estimating prevalence of HIV in pregnant women would aid in developing and prioritizing prevention of parent-to-child transmission of HIV programs. Materials and Methods: All pregnant women referred to the antenatal clinic from 1993 onward were tested for HIV infection by ELISA test after pretest counseling. A woman was diagnosed to be HIV infected if she tested positive on more than two HIV ELISA tests. Prevalence of HIV infection in them was calculated and also whether there was an increasing trend was determined. Results: A total of 123,439 pregnant women were tested for HIV from 1993 to 2004, of which 1797 women were HIV infected. Overall, the prevalence rate was found to be 1.4%. Prevalence rose from 0.76% in 1993 to 2.37% in 1998. However, from 2004, the prevalence has decreased to 0.6%. Conclusion: Prevalence of HIV in pregnant women in Mumbai is decreasing. PMID:29302524

  16. Cancer clinical trials in persons with HIV infection.

    Science.gov (United States)

    Little, Richard F

    2017-01-01

    The era of modern HIV therapeutics is well underway. The cancer and infectious disease epidemiology of HIV disease has markedly altered as populations are availed to the benefits of antiretroviral therapy (ARV). The types of cancers occurring among those with HIV infection has broadened but the case burden in absolute numbers is very low relative to the background population. There are fewer incident cases of the AIDS-defining cancers (aggressive B-cell lymphomas, Kaposi's sarcoma, and cervical cancer). There is an increased risk for certain non-AIDS-defining cancers, but these occur somewhat sporadically relative to clinical trial enrollment. The changing epidemiology of cancer in HIV poses challenges as well as opportunities for participation of persons with HIV in cancer therapy clinical trials. There are excellent examples of cancer trials that inform cancer therapy for patients with HIV infection. Examples include those from HIV-specific trials and from trials mainly focused on the background population that included patients with HIV infection. Interpretation of clinical trials to guide therapy for those with HIV infection and cancer largely depends on data that does not include HIV-infected patients. The ability to extend clinical trial findings to populations not included in clinical trials remains problematic for a variety of populations, including those with HIV or AIDS. Careful prioritization of studies designed to bridge this gap is needed. However, there are published studies that serve as excellent examples bridging these gaps and the portfolio of cancer therapy trials underway will inform HIV and cancer better than at any time in the past.

  17. HIV/AIDS Coinfection

    Science.gov (United States)

    ... Coinfection Hepatitis C Coinfection HIV/AIDS Coinfection HIV/AIDS Coinfection Approximately 10% of the HIV-infected population ... Control and Prevention website to learn about HIV/AIDS and Viral Hepatitis guidelines and resources. Home About ...

  18. HIV/AIDS

    Science.gov (United States)

    HIV stands for human immunodeficiency virus. It harms your immune system by destroying the white blood cells ... It is the final stage of infection with HIV. Not everyone with HIV develops AIDS. HIV most ...

  19. HIV and Immunizations

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets HIV ... 4 p.m. ET) Send us an email HIV and Immunizations Last Reviewed: February 6, 2018 Key ...

  20. HIV Medication Adherence

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets HIV ... 4 p.m. ET) Send us an email HIV Medication Adherence Last Reviewed: January 17, 2018 Key ...

  1. HIV and AIDS

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español HIV and AIDS KidsHealth / For Kids / HIV and AIDS ... actually the virus that causes the disease AIDS. HIV Hurts the Immune System People who are HIV ...

  2. HIV Treatment: The Basics

    Science.gov (United States)

    ... AIDS Drugs Clinical Trials Apps skip to content HIV Treatment Home Understanding HIV/AIDS Fact Sheets HIV ... 4 p.m. ET) Send us an email HIV Treatment: The Basics Last Reviewed: March 22, 2018 ...

  3. HIV and Pregnancy

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG HIV and Pregnancy Home For Patients Search FAQs HIV ... HIV and Pregnancy FAQ113, July 2017 PDF Format HIV and Pregnancy Pregnancy What is human immunodeficiency virus ( ...

  4. HIV and Cardiovascular Disease

    Science.gov (United States)

    ... Select a Language: Fact Sheet 652 HIV and Cardiovascular Disease HIV AND CARDIOVASCULAR DISEASE WHY SHOULD PEOPLE WITH HIV CARE ABOUT CVD? ... OF CVD? WHAT ABOUT CHANGING MEDICATIONS? HIV AND CARDIOVASCULAR DISEASE Cardiovascular disease (CVD) includes a group of problems ...

  5. Faith and HIV prevention: the conceptual framing of HIV prevention among Pentecostal Batswana teenagers.

    Science.gov (United States)

    Mpofu, Elias; Nkomazana, Fidelis; Muchado, Jabulani A; Togarasei, Lovemore; Bingenheimer, Jeffrey Bart

    2014-03-05

    There is a huge interest by faith-based organizations (FBOs) in sub-Saharan Africa and elsewhere in HIV prevention interventions that build on the religious aspects of being. Successful partnerships between the public health services and FBOs will require a better understanding of the conceptual framing of HIV prevention by FBOS to access for prevention intervention, those concepts the churches of various denominations and their members would support or endorse. This study investigated the conceptual framing of HIV prevention among church youths in Botswana;--a country with one of the highest HIV prevalence in the world. Participants were 213 Pentecostal church members (67% female; age range 12 to 23 years; median age=19 years). We engaged the participants in a mixed-method inductive process to collect data on their implicit framing of HIV prevention concepts, taking into account the centrality of religion concepts to them and the moderating influences of age, gender and sexual experience. After, we analysed the data using multi-dimensional scaling (MDS) and hierarchical cluster analysis (HCA) to map the ways the church youths framed HIV prevention. The findings suggest the church youth to conceptually frame their HIV prevention from both faith-oriented and secular-oriented perspectives, while prioritizing the faith-oriented concepts based on biblical teachings and future focus. In their secular-oriented framing of HIV prevention, the church youths endorsed the importance to learn the facts about HIV and AIDS, understanding of community norms that increased risk for HIV and prevention education. However, components of secular-oriented framing of HIV prevention concepts were comparatively less was well differentiated among the youths than with faith-oriented framing, suggesting latent influences of the church knowledge environment to undervalue secular oriented concepts. Older and sexually experienced church youths in their framing of HIV prevention valued future

  6. Oral manifestations among people living with HIV/AIDS in Tanzania

    DEFF Research Database (Denmark)

    Fabian, F M; Kahabuka, F K; Petersen, P E

    2009-01-01

    BACKGROUND: This study aimed to determine the prevalence of various oral and peri-oral manifestations in people living with HIV/AIDS in Tanzania. METHODS: A cross sectional study. A total of 187 persons with HIV infection were recruited from non-governmental organisations serving people living...... associated with low body mass index (BMI). CONCLUSION: This community survey carried out in an African sub-Saharan country showed that oral lesions are frequent among people living with HIV/AIDS. As emphasised by the World Health Organization Global Oral Health Programme, national HIV/AIDS programmes should...

  7. Finnish bioenergy research programme

    Energy Technology Data Exchange (ETDEWEB)

    Asplund, D. [VTT Energy, Jyvaeskylae (Finland)

    1996-12-31

    Finland is a leading country in the use of biofuels and has excellent opportunities to increase the use of biofuels by up to 25-30 %. The Finnish Government has set an objective for the promotion of bioenergy. The aim is to increase the use of bioenergy by about 25 % from the present level by 2005, and the increment corresponds to 1.5 million tonnes of oil equivalent (toe) per year. The R and D work has been considered as an important factor to achieve this ambitious goal. Energy research was organised into a series of research programmes in 1988 in accordance with the proposal of Finnish Energy Research Committee. The object of the research programmes is to enhance research activities and to bundle individual projects together into larger research packages. The common target of the Finnish energy research programmes is to proceed from basic and applied research to product development and pilot operation, and after that to the first commercial applications, e.g. demonstrations. As the organisation of energy research to programmes has led to good results, the Finnish Ministry of Trade and Industry decided to go on with this practice by launching new six-year programmes in 1993-1998. One of these programmes is the Bioenergy Research Programme and the co-ordination of this programme is carried out by VTT Energy. Besides VTT Energy the Finnish Forest Research Institute, Work Efficiency Institute, Metsaeteho and University of Joensuu are participating in the programme 7 refs.

  8. Finnish bioenergy research programme

    Energy Technology Data Exchange (ETDEWEB)

    Asplund, D [VTT Energy, Jyvaeskylae (Finland)

    1997-12-31

    Finland is a leading country in the use of biofuels and has excellent opportunities to increase the use of biofuels by up to 25-30 %. The Finnish Government has set an objective for the promotion of bioenergy. The aim is to increase the use of bioenergy by about 25 % from the present level by 2005, and the increment corresponds to 1.5 million tonnes of oil equivalent (toe) per year. The R and D work has been considered as an important factor to achieve this ambitious goal. Energy research was organised into a series of research programmes in 1988 in accordance with the proposal of Finnish Energy Research Committee. The object of the research programmes is to enhance research activities and to bundle individual projects together into larger research packages. The common target of the Finnish energy research programmes is to proceed from basic and applied research to product development and pilot operation, and after that to the first commercial applications, e.g. demonstrations. As the organisation of energy research to programmes has led to good results, the Finnish Ministry of Trade and Industry decided to go on with this practice by launching new six-year programmes in 1993-1998. One of these programmes is the Bioenergy Research Programme and the co-ordination of this programme is carried out by VTT Energy. Besides VTT Energy the Finnish Forest Research Institute, Work Efficiency Institute, Metsaeteho and University of Joensuu are participating in the programme 7 refs.

  9. Locating People Diagnosed With HIV for Public Health Action: Utility of HIV Case Surveillance and Other Data Sources.

    Science.gov (United States)

    Padilla, Mabel; Mattson, Christine L; Scheer, Susan; Udeagu, Chi-Chi N; Buskin, Susan E; Hughes, Alison J; Jaenicke, Thomas; Wohl, Amy Rock; Prejean, Joseph; Wei, Stanley C

    Human immunodeficiency virus (HIV) case surveillance and other health care databases are increasingly being used for public health action, which has the potential to optimize the health outcomes of people living with HIV (PLWH). However, often PLWH cannot be located based on the contact information available in these data sources. We assessed the accuracy of contact information for PLWH in HIV case surveillance and additional data sources and whether time since diagnosis was associated with accurate contact information in HIV case surveillance and successful contact. The Case Surveillance-Based Sampling (CSBS) project was a pilot HIV surveillance system that selected a random population-based sample of people diagnosed with HIV from HIV case surveillance registries in 5 state and metropolitan areas. From November 2012 through June 2014, CSBS staff members attempted to locate and interview 1800 sampled people and used 22 data sources to search for contact information. Among 1063 contacted PLWH, HIV case surveillance data provided accurate telephone number, address, or HIV care facility information for 239 (22%), 412 (39%), and 827 (78%) sampled people, respectively. CSBS staff members used additional data sources, such as support services and commercial people-search databases, to locate and contact PLWH with insufficient contact information in HIV case surveillance. PLWH diagnosed surveillance than were PLWH diagnosed ≥1 year ago ( P = .002), and the benefit from using additional data sources was greater for PLWH with more longstanding HIV infection ( P surveillance cannot provide accurate contact information, health departments can prioritize searching additional data sources, especially for people with more longstanding HIV infection.

  10. Prioritizing resources for treatment of HIV/AIDS in resource poor ...

    African Journals Online (AJOL)

    After two decades of war, South Sudan is facing a new challenge of ... discrimination. There is limited access to entry points ... focus more on outreaches at market places and schools. .... been the traditional mode of entry into much needed.

  11. HIV/AIDS - Multiple Languages

    Science.gov (United States)

    ... HIV - Newly diagnosed with HIV, part 5 - English MP3 Children and HIV - Newly diagnosed with HIV, part 5 - 简体中文 (Chinese, Simplified (Mandarin dialect)) MP3 Children and HIV - Newly diagnosed with HIV, part ...

  12. Basic HIV/AIDS Statistics

    Science.gov (United States)

    ... HIV Syndicated Content Website Feedback HIV/AIDS Basic Statistics Recommend on Facebook Tweet Share Compartir HIV and ... HIV. Interested in learning more about CDC's HIV statistics? Terms, Definitions, and Calculations Used in CDC HIV ...

  13. Living with HIV

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... Syndicated Content Website Feedback HIV/AIDS Living With HIV Language: English (US) Español (Spanish) Recommend on Facebook ...

  14. HIV Risk and Prevention

    Science.gov (United States)

    ... Prevention VIH En Español Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... Email Updates on HIV Syndicated Content Website Feedback HIV Risk and Prevention Recommend on Facebook Tweet Share ...

  15. Global Epidemiology of HIV Infection and Related Syndemics Affecting Transgender People

    Science.gov (United States)

    Scheim, Ayden; Xavier, Jessica; Reisner, Sari; Baral, Stefan

    2016-01-01

    Introduction: Transgender populations have been underrepresented in HIV epidemiologic studies and consequently in HIV prevention, care, and treatment programs. Since 2012, there has been a dramatic increase in research focused on transgender people. Studies highlight the burden of HIV and risk determinants, including intersecting stigmas, as drivers of syndemics among transgender populations. This review synthesizes the most recent global epidemiology of HIV infection and describes current gaps in research and interventions to inform prioritization of HIV research for transgender populations. Methods: A systematic review was conducted of the medical literature published between January 1, 2012 and November 30, 2015. The data focused on HIV prevalence, determinants of risk, and syndemics among transgender populations. Results: Estimates varied dramatically by location and subpopulation. Transfeminine individuals have some of the highest concentrated HIV epidemics in the world with laboratory-confirmed prevalence up to 40%. Data were sparse among trans masculine individuals; however, they suggest potential increased risk for trans masculine men who have sex with men (MSM). No prevalence data were available for transgender people across Sub-Saharan Africa or Eastern Europe/Central Asia. Emerging data consistently support the association of syndemic conditions with HIV risk in transgender populations. Discussion: Addressing syndemic conditions and gender-specific challenges is critical to ensure engagement and retention in HIV prevention by transgender populations. Future research should prioritize: filling knowledge gaps in HIV epidemiology; elucidating how stigma shapes syndemic factors to produce HIV and other deleterious effects on transgender health; and understanding how to effectively implement HIV interventions for transgender people. PMID:27429185

  16. Drawing AIDS:Tanzanian Teachers Picture the Pandemic: Implications for Re-Curriculation of Teacher Education Programmes

    Science.gov (United States)

    Wood, Lesley; de Lange, Naydene; Mkumbo, Kitila

    2013-01-01

    In this article, we explain how we engaged teachers in creating their own representations of HIV and AIDS in Tanzania as a starting point for re-curriculation of the undergraduate teacher education programme. We employed a qualitative design, using visual methodologies, to encourage 29 in-service teachers to draw their perceptions about HIV and…

  17. Prioritizing Risk in Preparation for a Demonstration Project: A Mixed Methods Feasibility Study of Oral Pre-Exposure Prophylaxis (PREP) among Female Sex Workers in South India.

    Science.gov (United States)

    Reza-Paul, Sushena; Lazarus, Lisa; Doshi, Monika; Hafeez Ur Rahman, Syed; Ramaiah, Manjula; Maiya, Raviprakash; Ms, Venugopal; Venukumar, K T; Sundararaman, Sundar; Becker, Marissa; Moses, Stephen; Lorway, Robert

    2016-01-01

    HIV prevalence among female sex workers (FSWs) in India remains well above the national average. Pre-exposure prophylaxis (PrEP), a new HIV prevention technology, may help to reduce HIV incidence, but there is a dearth of research that can inform the potential scale-up of PrEP in India. In partnership with Ashodaya Samithi, a local sex worker collective, we conducted a feasibility study to assess acceptance of a planned PrEP demonstration project, willingness to use PrEP, and recommendations for project roll-out among FSWs in southern Karnataka. From January-April 2015, 6 focus group discussions, 47 in-depth interviews, and 427 interviewer-administered questionnaires were completed by female sex workers. All participants were 18 years of age or older and practiced sex work. Qualitative data were coded for key themes and emergent categories. Univariate descriptive analysis was employed to summarise the quantitative data. Qualitative. PrEP was described as an exciting new prevention technology that places control in the hands of FSWs and provides a "double safety" in combination with condom use. Participants expressed agreement that women who may experience more HIV risk in their occupational environments should be prioritized for enrollment into a demonstration project. Quantitative. 406 participants (95%) expressed interest in PrEP. Participants prioritized the inclusion of FSWs under the age of 25 (79%), those who do not use condoms when clients offer more money (58%), who do not consistently use condoms with regular partners (57%), who drink alcohol regularly (49%), and who do not use condoms consistently with clients (48%). This feasibility study indicated strong interest in PrEP and a desire to move forward with the demonstration project. Participants expressed their responses in terms of public health discourses surrounding risk, pointing to the importance of situating PrEP scale up within the trusted spaces of community-based organizations as a means of

  18. HIV surveillance in MENA: recent developments and results.

    Science.gov (United States)

    Bozicevic, Ivana; Riedner, Gabriele; Calleja, Jesus Maria Garcia

    2013-11-01

    To provide an overview of the current level of development and results from the national HIV surveillance systems of the 23 countries of the Middle East and North Africa (MENA), and to assess the quality of HIV surveillance systems in the period 2007-2011. A questionnaire was used to collect the information about the structure, activities and the results of HIV surveillance systems from the National AIDS Programmes. Assessment of the quality was based on four indicators: timeliness of data collection, appropriateness of populations under surveillance, consistency of the surveillance sites and groups measured over time, and coverage of the surveillance system. Only in four countries did surveillance systems enable assessment of epidemic trends in the same populations and locations over time, such as in pregnant women (Morocco, Iran), injecting drug users (Iran, Pakistan), female sex workers (Djibouti, Morocco) and male sex workers (Pakistan). There is increasing evidence of HIV infection being firmly established in at least one of the populations most at risk of HIV in nine MENA countries, while lower risk populations show elevated HIV prevalence in South Sudan, Djibouti and some parts of Somalia. The performance of HIV surveillance systems in several of the MENA countries has improved in recent years. The extent of HIV epidemics in the populations most at risk of HIV is still largely unknown in 10 countries. Multiple data sources that most of the countries still lack would enable indirectly estimation not only of the patterns of HIV epidemics but also the effectiveness of HIV responses.

  19. Prioritization of Attributes for Palletizing Robots in Beverage Industry of Pakistan

    Directory of Open Access Journals (Sweden)

    BILAL AHMED

    2017-07-01

    Full Text Available Robots are extensively used in modern manufacturing industries to perform numerous repetitive operations. The challenge of selecting the most appropriate robot for a particular manufacturing setup is progressively becoming complex as there are numerous selection criteria and more alternatives available in market. Only a limited amount of research is available in literature which focuses on the selection of industrial robots for beverage industry. This study offers a country specific application of AHP (Analytical Hierarchy Process in problem of palletizing robot selection for beverage industry of Pakistan. The problem is structured in standard AHP hierarchy and equations. The factors initially explored from the concerned literature are prioritized by the industry experts. The available robot alternatives are evaluated for each parameter and results are computed with the help of Exert Choice, a commercial AHP software. It is observed that experts in Pakistan beverage industry are very sensitive to operating costs of the robots and they do not assign as much weightage to technical parameters like repeatability and programmability. The robots with lesser associated costs and better speed and ?manipulator reach? are higher in ranking. The findings are beneficial for the international investors and local beverage industry managers to corroborate the current trends and preferences of the said industry.

  20. Prioritization of attributes for palletizing robots in beverage industry of pakistan

    International Nuclear Information System (INIS)

    Ahmed, B.; Ali, H.M.K.; Sultan, A.; Rana, B.B.

    2017-01-01

    Robots are extensively used in modern manufacturing industries to perform numerous repetitive operations. The challenge of selecting the most appropriate robot for a particular manufacturing setup is progressively becoming complex as there are numerous selection criteria and more alternatives available in market. Only a limited amount of research is available in literature which focuses on the selection of industrial robots for beverage industry. This study offers a country specific application of AHP (Analytical Hierarchy Process) in problem of palletizing robot selection for beverage industry of Pakistan. The problem is structured in standard AHP hierarchy and equations. The factors initially explored from the concerned literature are prioritized by the industry experts. The available robot alternatives are evaluated for each parameter and results are computed with the help of Exert Choice, a commercial AHP software. It is observed that experts in Pakistan beverage industry are very sensitive to operating costs of the robots and they do not assign as much weightage to technical parameters like repeatability and programmability. The robots with lesser associated costs and better speed and 'manipulator reach' are higher in ranking. The findings are beneficial for the international investors and local beverage industry managers to corroborate the current trends and preferences of the said industry. (author)

  1. Effect of risk aversion on prioritizing conservation projects.

    Science.gov (United States)

    Tulloch, Ayesha I T; Maloney, Richard F; Joseph, Liana N; Bennett, Joseph R; Di Fonzo, Martina M I; Probert, William J M; O'Connor, Shaun M; Densem, Jodie P; Possingham, Hugh P

    2015-04-01

    Conservation outcomes are uncertain. Agencies making decisions about what threat mitigation actions to take to save which species frequently face the dilemma of whether to invest in actions with high probability of success and guaranteed benefits or to choose projects with a greater risk of failure that might provide higher benefits if they succeed. The answer to this dilemma lies in the decision maker's aversion to risk--their unwillingness to accept uncertain outcomes. Little guidance exists on how risk preferences affect conservation investment priorities. Using a prioritization approach based on cost effectiveness, we compared 2 approaches: a conservative probability threshold approach that excludes investment in projects with a risk of management failure greater than a fixed level, and a variance-discounting heuristic used in economics that explicitly accounts for risk tolerance and the probabilities of management success and failure. We applied both approaches to prioritizing projects for 700 of New Zealand's threatened species across 8303 management actions. Both decision makers' risk tolerance and our choice of approach to dealing with risk preferences drove the prioritization solution (i.e., the species selected for management). Use of a probability threshold minimized uncertainty, but more expensive projects were selected than with variance discounting, which maximized expected benefits by selecting the management of species with higher extinction risk and higher conservation value. Explicitly incorporating risk preferences within the decision making process reduced the number of species expected to be safe from extinction because lower risk tolerance resulted in more species being excluded from management, but the approach allowed decision makers to choose a level of acceptable risk that fit with their ability to accommodate failure. We argue for transparency in risk tolerance and recommend that decision makers accept risk in an adaptive management

  2. Prioritizing land and sea conservation investments to protect coral reefs.

    Directory of Open Access Journals (Sweden)

    Carissa J Klein

    Full Text Available BACKGROUND: Coral reefs have exceptional biodiversity, support the livelihoods of millions of people, and are threatened by multiple human activities on land (e.g. farming and in the sea (e.g. overfishing. Most conservation efforts occur at local scales and, when effective, can increase the resilience of coral reefs to global threats such as climate change (e.g. warming water and ocean acidification. Limited resources for conservation require that we efficiently prioritize where and how to best sustain coral reef ecosystems. METHODOLOGY/PRINCIPAL FINDINGS: Here we develop the first prioritization approach that can guide regional-scale conservation investments in land- and sea-based conservation actions that cost-effectively mitigate threats to coral reefs, and apply it to the Coral Triangle, an area of significant global attention and funding. Using information on threats to marine ecosystems, effectiveness of management actions at abating threats, and the management and opportunity costs of actions, we calculate the rate of return on investment in two conservation actions in sixteen ecoregions. We discover that marine conservation almost always trumps terrestrial conservation within any ecoregion, but terrestrial conservation in one ecoregion can be a better investment than marine conservation in another. We show how these results could be used to allocate a limited budget for conservation and compare them to priorities based on individual criteria. CONCLUSIONS/SIGNIFICANCE: Previous prioritization approaches do not consider both land and sea-based threats or the socioeconomic costs of conserving coral reefs. A simple and transparent approach like ours is essential to support effective coral reef conservation decisions in a large and diverse region like the Coral Triangle, but can be applied at any scale and to other marine ecosystems.

  3. Prioritizing conservation areas for coastal plant diversity under increasing urbanization.

    Science.gov (United States)

    Doxa, Aggeliki; Albert, Cécile Hélène; Leriche, Agathe; Saatkamp, Arne

    2017-10-01

    Coastal urban expansion will continue to drive further biodiversity losses, if conservation targets for coastal ecosystems are not defined and met. Prioritizing areas for future protected area networks is thus an urgent task in such urbanization-threatened ecosystems. Our aim is to quantify past and future losses of coastal vegetation priority areas due to urbanization and assess the effectiveness of the existing protected area network for conservation. We conduct a prioritization analysis, based on 82 coastal plants, including common and IUCN red list species, in a highly-urbanized but biotically diverse region, in South-Eastern France. We evaluate the role of protected areas, by taking into account both strict and multi-use areas. We assess the impact of past and future urbanization on high priority areas, by combining prioritization analyses and urbanization models. We show that half of the highly diverse areas have already been lost due to urbanization. Remaining top priority areas are also among the most exposed to future urban expansion. The effectiveness of the existing protected area (PA) network is only partial. While strict PAs coincide well with top priority areas, they only represent less than one third of priority areas. The effectiveness of multi-use PAs, such as the Natura 2000 network, also remains limited. Our approach highlights the impact of urbanization on plant conservation targets. By modelling urbanization, we manage to identify those areas where protection could be more efficient to limit further losses. We suggest to use our approach in the future to expand the PA network in order to achieve the 2020 Aichi biodiversity targets. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Prioritization strategies in clinical practice guidelines development: a pilot study

    Directory of Open Access Journals (Sweden)

    Torres Marcela

    2010-03-01

    Full Text Available Abstract Objective Few methodological studies address the prioritization of clinical topics for the development of Clinical Practice Guidelines (CPGs. The aim of this study was to validate a methodology for Priority Determination of Topics (PDT of CPGs. Methods and results Firstly, we developed an instrument for PDT with 41 criteria that were grouped under 10 domains, based on a comprehensive systematic search. Secondly, we performed a survey of stakeholders involved in CPGs development, and end users of guidelines, using the instrument. Thirdly, a pilot testing of the PDT procedure was performed in order to choose 10 guideline topics among 34 proposed projects; using a multi-criteria analysis approach, we validated a mechanism that followed five stages: determination of the composition of groups, item/domain scoring, weights determination, quality of the information used to support judgments, and finally, topic selection. Participants first scored the importance of each domain, after which four different weighting procedures were calculated (including the survey results. The process of weighting was determined by correlating the data between them. We also reported the quality of evidence used for PDT. Finally, we provided a qualitative analysis of the process. The main domains used to support judgement, having higher quality scores and weightings, were feasibility, disease burden, implementation and information needs. Other important domains such as user preferences, adverse events, potential for health promotion, social effects, and economic impact had lower relevance for clinicians. Criteria for prioritization were mainly judged through professional experience, while good quality information was only used in 15% of cases. Conclusion The main advantages of the proposed methodology are supported by the use of a systematic approach to identify, score and weight guideline topics selection, limiting or exposing the influence of personal biases

  5. Enabling task-based information prioritization via semantic web encodings

    Science.gov (United States)

    Michaelis, James R.

    2016-05-01

    Modern Soldiers rely upon accurate and actionable information technology to achieve mission objectives. While increasingly rich sensor networks for Areas of Operation (AO) can offer many directions for aiding Soldiers, limitations are imposed by current tactical edge systems on the rate that content can be transmitted. Furthermore, mission tasks will often require very specific sets of information which may easily be drowned out by other content sources. Prior research on Quality and Value of Information (QoI/VoI) has aimed to define ways to prioritize information objects based on their intrinsic attributes (QoI) and perceived value to a consumer (VoI). As part of this effort, established ranking approaches for obtaining Subject Matter Expert (SME) recommendations, such as the Analytic Hierarchy Process (AHP) have been considered. However, limited work has been done to tie Soldier context - such as descriptions of their mission and tasks - back to intrinsic attributes of information objects. As a first step toward addressing the above challenges, this work introduces an ontology-backed approach - rooted in Semantic Web publication practices - for expressing both AHP decision hierarchies and corresponding SME feedback. Following a short discussion on related QoI/VoI research, an ontology-based data structure is introduced for supporting evaluation of Information Objects, using AHP rankings designed to facilitate information object prioritization. Consistent with alternate AHP approaches, prioritization in this approach is based on pairwise comparisons between Information Objects with respect to established criteria, as well as on pairwise comparison of the criteria to assess their relative importance. The paper concludes with a discussion of both ongoing and future work.

  6. Prioritizing land and sea conservation investments to protect coral reefs.

    Science.gov (United States)

    Klein, Carissa J; Ban, Natalie C; Halpern, Benjamin S; Beger, Maria; Game, Edward T; Grantham, Hedley S; Green, Alison; Klein, Travis J; Kininmonth, Stuart; Treml, Eric; Wilson, Kerrie; Possingham, Hugh P

    2010-08-30

    Coral reefs have exceptional biodiversity, support the livelihoods of millions of people, and are threatened by multiple human activities on land (e.g. farming) and in the sea (e.g. overfishing). Most conservation efforts occur at local scales and, when effective, can increase the resilience of coral reefs to global threats such as climate change (e.g. warming water and ocean acidification). Limited resources for conservation require that we efficiently prioritize where and how to best sustain coral reef ecosystems. Here we develop the first prioritization approach that can guide regional-scale conservation investments in land- and sea-based conservation actions that cost-effectively mitigate threats to coral reefs, and apply it to the Coral Triangle, an area of significant global attention and funding. Using information on threats to marine ecosystems, effectiveness of management actions at abating threats, and the management and opportunity costs of actions, we calculate the rate of return on investment in two conservation actions in sixteen ecoregions. We discover that marine conservation almost always trumps terrestrial conservation within any ecoregion, but terrestrial conservation in one ecoregion can be a better investment than marine conservation in another. We show how these results could be used to allocate a limited budget for conservation and compare them to priorities based on individual criteria. Previous prioritization approaches do not consider both land and sea-based threats or the socioeconomic costs of conserving coral reefs. A simple and transparent approach like ours is essential to support effective coral reef conservation decisions in a large and diverse region like the Coral Triangle, but can be applied at any scale and to other marine ecosystems.

  7. Sensory Prioritization in Rats: Behavioral Performance and Neuronal Correlates.

    Science.gov (United States)

    Lee, Conrad C Y; Diamond, Mathew E; Arabzadeh, Ehsan

    2016-03-16

    Operating with some finite quantity of processing resources, an animal would benefit from prioritizing the sensory modality expected to provide key information in a particular context. The present study investigated whether rats dedicate attentional resources to the sensory modality in which a near-threshold event is more likely to occur. We manipulated attention by controlling the likelihood with which a stimulus was presented from one of two modalities. In a whisker session, 80% of trials contained a brief vibration stimulus applied to whiskers and the remaining 20% of trials contained a brief change of luminance. These likelihoods were reversed in a visual session. When a stimulus was presented in the high-likelihood context, detection performance increased and was faster compared with the same stimulus presented in the low-likelihood context. Sensory prioritization was also reflected in neuronal activity in the vibrissal area of primary somatosensory cortex: single units responded differentially to the whisker vibration stimulus when presented with higher probability compared with lower probability. Neuronal activity in the vibrissal cortex displayed signatures of multiplicative gain control and enhanced response to vibration stimuli during the whisker session. In conclusion, rats allocate priority to the more likely stimulus modality and the primary sensory cortex may participate in the redistribution of resources. Detection of low-amplitude events is critical to survival; for example, to warn prey of predators. To formulate a response, decision-making systems must extract minute neuronal signals from the sensory modality that provides key information. Here, we identify the behavioral and neuronal correlates of sensory prioritization in rats. Rats were trained to detect whisker vibrations or visual flickers. Stimuli were embedded in two contexts in which either visual or whisker modality was more likely to occur. When a stimulus was presented in the high

  8. Robust and accurate multi-view reconstruction by prioritized matching

    DEFF Research Database (Denmark)

    Ylimaki, Markus; Kannala, Juho; Holappa, Jukka

    2012-01-01

    a prioritized matching method which expands the most promising seeds first. The output of the method is a three-dimensional point cloud. Unlike previous correspondence growing approaches our method allows to use the best-first matching principle in the generic multi-view stereo setting with arbitrary number...... of input images. Our experiments show that matching the most promising seeds first provides very robust point cloud reconstructions efficiently with just a single expansion step. A comparison to the current state-of-the-art shows that our method produces reconstructions of similar quality but significantly...

  9. Gene prioritization for livestock diseases by data integration

    DEFF Research Database (Denmark)

    Jiang, Li; Sørensen, Peter; Thomsen, Bo Stjerne

    2012-01-01

    in bovine mastitis. Gene-associated phenome profile and transcriptome profile in response to Escherichia coli infection in the mammary gland were integrated to make a global inference of bovine genes involved in mastitis. The top ranked genes were highly enriched for pathways and biological processes...... underlying inflammation and immune responses, which supports the validity of our approach for identifying genes that are relevant to animal health and disease. These gene-associated phenotypes were used for a local prioritization of candidate genes located in a QTL affecting the susceptibility to mastitis...

  10. Neural Signature of Value-Based Sensorimotor Prioritization in Humans.

    Science.gov (United States)

    Blangero, Annabelle; Kelly, Simon P

    2017-11-01

    In situations in which impending sensory events demand fast action choices, we must be ready to prioritize higher-value courses of action to avoid missed opportunities. When such a situation first presents itself, stimulus-action contingencies and their relative value must be encoded to establish a value-biased state of preparation for an impending sensorimotor decision. Here, we sought to identify neurophysiological signatures of such processes in the human brain (both female and male). We devised a task requiring fast action choices based on the discrimination of a simple visual cue in which the differently valued sensory alternatives were presented 750-800 ms before as peripheral "targets" that specified the stimulus-action mapping for the upcoming decision. In response to the targets, we identified a discrete, transient, spatially selective signal in the event-related potential (ERP), which scaled with relative value and strongly predicted the degree of behavioral bias in the upcoming decision both across and within subjects. This signal is not compatible with any hitherto known ERP signature of spatial selection and also bears novel distinctions with respect to characterizations of value-sensitive, spatially selective activity found in sensorimotor areas of nonhuman primates. Specifically, a series of follow-up experiments revealed that the signal was reliably invoked regardless of response laterality, response modality, sensory feature, and reward valence. It was absent, however, when the response deadline was relaxed and the strategic need for biasing removed. Therefore, more than passively representing value or salience, the signal appears to play a versatile and active role in adaptive sensorimotor prioritization. SIGNIFICANCE STATEMENT In many situations such as fast-moving sports, we must be ready to act fast in response to sensory events and, in our preparation, prioritize courses of action that lead to greater rewards. Although behavioral effects of

  11. Prioritization of Workplace Practices: Evidence from Islamic financial institutions

    Directory of Open Access Journals (Sweden)

    Faizah Darus

    2016-01-01

    Full Text Available The aim of this study is to examine the prioritization of workplace practices among Islamic financial institutions in Malaysia for 2012. A content analysis of the annual and sustainability reports were carried out to examine the extensiveness of disclosure relating to information on workplace practices. An Islamic workplace index was used to evaluate the workplace disclosure. The results of the study revealed that skill enhancement and employees-management engagement were the focus for workplace environment among Islamic financial institutions. Particularly, information relating to incentives and bonuses were found to be the most extensively disclosed information.

  12. Interaction Matrices as a Tool for Prioritizing Radioecology Research

    Energy Technology Data Exchange (ETDEWEB)

    Mora, J.C.; Robles, Beatriz [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas - CIEMAT (Spain); Bradshaw, Clare; Stark, Karolina [Stockholm University (Sweden); Sweeck, Liev; Vives i Batlle, Jordi [Belgian Nuclear Research Centre SCK-CEN (Belgium); Beresford, Nick [Centre for Ecology and Hydrology - CEH (United Kingdom); Thoerring, Havard; Dowdall, Mark [Norwegian Radiation Protection Authority - NRPA (Norway); Outola, Iisa; Turtiainen, Tuukka; Vetikko, Virve [STUK - Radiation and Nuclear Safety Authority (Finland); Steiner, Martin [Federal Office for Radiation Protection - BfS (Germany); Beaugelin-Seiller, Karine; Fevrier, Laureline; Hurtevent, Pierre; Boyer, Patrick [Institut de Radioprotection et de Surete Nucleaire - IRSN (France)

    2014-07-01

    Interaction Matrices as a Tool for Prioritizing Radioecology Research J.C. Mora CIEMAT In 2010 the Strategy for Allied Radioecology (STAR) was launched with several objectives aimed towards integrating the radioecology research efforts of nine institutions in Europe. One of these objectives was the creation of European Radioecology Observatories. The Chernobyl Exclusion Zone (CEZ) and the Upper Silesian Coal Basin (USCB), a coal mining area in Poland, have been chosen after a selection process. A second objective was to develop a system for improving and validating the capabilities of predicting the behaviour of the main radionuclides existing at these observatories. Interaction Matrices (IM) have been used since the 1990's as a tool for developing ecological conceptual models and have also been used within radioecology. The Interaction Matrix system relies on expert judgement for structuring knowledge of a given ecosystem at the conceptual level and was selected for use in the STAR project. A group of experts, selected from each institution of STAR, designed two matrices with the main compartments for each ecosystem (a forest in CEZ and a lake in USCB). All the features, events and processes (FEPs) which could affect the behaviour of the considered radionuclides, focusing on radiocaesium in the Chernobyl forest and radium in the Rontok-Wielki lake, were also included in each IM. Two new sets of experts were appointed to review, improve and prioritize the processes included in each IM. A first processing of the various candidate interaction matrices produced a single interaction matrix for each ecosystem which incorporated all experts combined knowledge. During the prioritization of processes in the IMs, directed towards developing a whole predictive model of radionuclides behaviour in those ecosystems, raised interesting issues related to the processes and parameters involved, regarding the existing knowledge in them. This exercise revealed several processes

  13. Fusion technology programme

    International Nuclear Information System (INIS)

    Finken, D.

    1984-04-01

    KfK participates to the Fusion Technology Programme of the European Community. Most of the work in progress addresses the Next European Torus (NET) and the long term technology aspects as defined in the 82/86 programme. A minor part serves to preparation of future contributions and to design studies on fusion concepts in a wider perspective. The Fusion Technology Programme of Euratom covers mainly aspects of nuclear engineering. Plasma engineering, heating, refueling and vacuum technology are at present part of the Physics Programme. In view of NET, integration of the different areas of work will be mandatory. KfK is therefore prepared to address technical aspects beyond the actual scope of the physics experiments. The technology tasks are reported project wise under title and code of the Euratom programme. Most of the projects described here are shared with other European fusion laboratories as indicated in the table annexed to this report. (orig./GG)

  14. The WHO AFRO external quality assessment programme (EQAP): Linking laboratory networks through EQA programmes.

    Science.gov (United States)

    Boeras, Debrah I; Peeling, Rosanna W; Onyebujoh, Philip; Yahaya, Ali A; Gumede-Moeletsi, Hieronyma N; Ndihokubwayo, Jean B

    2016-01-01

    External Quality Assessment (EQA) surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO) revealed the need for the strengthening of public health microbiology laboratories, particularly for testing of epidemic-prone diseases in the African Region. These surveys revealed common issues such as supply chain management, skilled personnel, logistical support and overall lack of quality standards. For sustainable improvements to health systems as well as global health security, deficiencies identified need to be actively corrected through robust quality assurance programmes and implementation of laboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programme with a focus on vaccine-preventable diseases and emerging and re-emerging dangerous pathogens is important, and should not be stand-alone, but integrated within laboratory networks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Prevention, the London School of Hygiene & Tropical Medicine and partners in a series of consultations with countries and national and regional EQA providers for the development of quality assurance models to support HIV point-of-care testing and monitoring. These consultations revealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forth its experience in implementing quality standards for health programmes, and also opened discussions on how lessons learned through such established programmes can be utilised to supporting and strengthening the introduction of early infant diagnosis of HIV and viral load point-of-care testing. An optimised external quality assessment programme will impact the ability of countries to meet core capacities, providing improved quality management systems, improving the confidence of diagnostic network services in Africa, and including capacities to detect events

  15. HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs.

    Directory of Open Access Journals (Sweden)

    David Wilson

    2015-06-01

    Full Text Available There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection "Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers" highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.

  16. HIV Programs for Sex Workers: Lessons and Challenges for Developing and Delivering Programs.

    Science.gov (United States)

    Wilson, David

    2015-06-01

    There is evidence that HIV prevention programs for sex workers, especially female sex workers, are cost-effective in several contexts, including many western countries, Thailand, India, the Democratic Republic of Congo, Kenya, and Zimbabwe. The evidence that sex worker HIV prevention programs work must not inspire complacency but rather a renewed effort to expand, intensify, and maximize their impact. The PLOS Collection "Focus on Delivery and Scale: Achieving HIV Impact with Sex Workers" highlights major challenges to scaling-up sex worker HIV prevention programs, noting the following: sex worker HIV prevention programs are insufficiently guided by understanding of epidemic transmission dynamics, situation analyses, and programmatic mapping; sex worker HIV and sexually transmitted infection services receive limited domestic financing in many countries; many sex worker HIV prevention programs are inadequately codified to ensure consistency and quality; and many sex worker HIV prevention programs have not evolved adequately to address informal sex workers, male and transgender sex workers, and mobile- and internet-based sex workers. Based on the wider collection of papers, this article presents three major clusters of recommendations: (i) HIV programs focused on sex workers should be prioritized, developed, and implemented based on robust evidence; (ii) national political will and increased funding are needed to increase coverage of effective sex worker HIV prevention programs in low and middle income countries; and (iii) comprehensive, integrated, and rapidly evolving HIV programs are needed to ensure equitable access to health services for individuals involved in all forms of sex work.

  17. From 'half-dead' to being 'free': resistance to HIV stigma, self-disclosure and support for PMTCT/HIV care among couples living with HIV in Kenya.

    Science.gov (United States)

    Spangler, Sydney A; Abuogi, Lisa L; Akama, Eliud; Bukusi, Elizabeth A; Helova, Anna; Musoke, Pamela; Nalwa, Wafula Z; Odeny, Thomas A; Onono, Maricianah; Wanga, Iris; Turan, Janet M

    2018-05-01

    In sub-Saharan Africa, self-disclosure of HIV-positive status may be a pivotal action for improving access to prevention of mother-to-child transmission services. However, understanding of HIV stigma and disclosure, and their effects on demand for care remains incomplete - particularly in the current context of new antiretroviral therapy guidelines. The purpose of this study was to explore these issues among self-disclosed couples living in southwest Kenya. We conducted 38 in-depth interviews with HIV-positive pregnant or postpartum women and their male partners. Of the 19 couples, 10 were HIV seroconcordant and 9 were serodiscordant. The textual analysis showed that HIV stigma continues to restrict full participation in community life and limit access to care by promoting fear, isolation and self-censorship. Against this backdrop, however, participants' narratives revealed varying forms and degrees of resistance to HIV stigma, which appeared to both produce and emerge from acts of self-disclosure. Such disclosure enabled participants to overcome fears and gain critical support for engaging in HIV care while further resisting HIV stigma. These findings suggest that programme interventions designed explicitly to stimulate and support processes of HIV stigma resistance and safe self-disclosure may be key to improving demand for and retention in HIV services.

  18. HIV prevention in favour of the choice-disabled in southern Africa: study protocol for a randomised controlled trial

    OpenAIRE

    Andersson, Neil; Cockcroft, Anne; Thabane, Lehana; Marokoane, Nobantu; Laetsang, Ditiro; Masisi, Mokgweetsi

    2013-01-01

    Background Most HIV prevention strategies assume beneficiaries can act on their prevention decisions. But some people are unable to do so. They are ?choice-disabled?. Economic and educational interventions can reduce sexual violence, but there is less evidence that they can reduce HIV. There is little research on complex interventions in HIV prevention, yet all countries in southern Africa implement combination prevention programmes. Methods/Design The primary objective is to reduce HIV infec...

  19. The application of Intervention Mapping in developing and implementing school-based sexuality and HIV/AIDS education in a developing country context: the case of Tanzania

    NARCIS (Netherlands)

    Mkumbo, K.; Schaalma, H.P.; Kaaya, S.; Leerlooijer, J.N.; Mbwambo, J.; Kilonzo, G.

    2009-01-01

    Aims: Effective sexuality and HIV/AIDS education programmes are needed to protect young people against HIV/AIDS and teenage pregnancy in Tanzania and other Sub-Saharan African countries. Using a theory- and evidence-based approach and adapting the programmes to local contexts, increases the

  20. HIV testing in Europe

    DEFF Research Database (Denmark)

    Sullivan, Ann K; Sperle, Ida; Raben, Dorthe

    2017-01-01

    BACKGROUND: An evaluation of the 2010 ECDC guidance on HIV testing, conducted in October 2015-January 2016, assessed its impact, added value, relevance and usability and the need for updated guidance. METHODS: Data sources were two surveys: one for the primary target audience (health policymakers...... and decision makers, national programme managers and ECDC official contact points in the European Union/European Economic Area (EU/EEA) countries and one for a broader target audience (clinicians, civil society organisations and international public health agencies); two moderated focus group discussions  (17...... participants each); webpage access data; a literature citation review; and an expert consultation (18 participants) to discuss the evaluation findings. RESULTS: Twenty-three of 28 primary target audience and 31 of 51 broader target audience respondents indicated the guidance was the most relevant when compared...

  1. The prioritization of open innovation determinants in banking

    Directory of Open Access Journals (Sweden)

    Tornjanski Vesna

    2015-01-01

    Full Text Available The research scope of the paper is prioritization of open innovation determinants in banking industry using an integrated application of qualitative and quantitative methods in the evaluation process. The research methods were implemented to compound the depth of experts' knowledge and experience on the one hand, and the precise mathematical reasoning, on the other, thus creating the objective and accurate basis for effective decision making. The overview of determinants of open innovations in banking industry has been obtained from the literature overview and the Delphi study conducted among 51 experts from banks in Serbia. Fifteen significant determinants within five dimensions were further evaluated through AHP decision-making method to prioritize them toward the development of the open innovation in banking. The research results show that effective application of open innovation in banking lies in formal reinforcement by management to integrate innovation into organizational policies and in designing dual structures that facilitate the initiation and implementation of an innovation, i.e. building an ambidextrous organization. The research findings and results introduced in this paper can be usefully applied and widely used by both academics and practitioners who are interested in applying the open innovation concept in banking industry.

  2. Enhancing employee capacity to prioritize health insurance benefits.

    Science.gov (United States)

    Danis, Marion; Goold, Susan Dorr; Parise, Carol; Ginsburg, Marjorie

    2007-09-01

    To demonstrate that employees can gain understanding of the financial constraints involved in designing health insurance benefits. While employees who receive their health insurance through the workplace have much at stake as the cost of health insurance rises, they are not necessarily prepared to constructively participate in prioritizing their health insurance benefits in order to limit cost. Structured group exercises. Employees of 41 public and private organizations in Northern California. Administration of the CHAT (Choosing Healthplans All Together) exercise in which participants engage in deliberation to design health insurance benefits under financial constraints. Change in priorities and attitudes about the need to exercise insurance cost constraints. Participants (N = 744) became significantly more cognizant of the need to limit insurance benefits for the sake of affordability and capable of prioritizing benefit options. Those agreeing that it is reasonable to limit health insurance coverage given the cost increased from 47% to 72%. It is both possible and valuable to involve employees in priority setting regarding health insurance benefits through the use of structured decision tools.

  3. Speeding disease gene discovery by sequence based candidate prioritization

    Directory of Open Access Journals (Sweden)

    Porteous David J

    2005-03-01

    Full Text Available Abstract Background Regions of interest identified through genetic linkage studies regularly exceed 30 centimorgans in size and can contain hundreds of genes. Traditionally this number is reduced by matching functional annotation to knowledge of the disease or phenotype in question. However, here we show that disease genes share patterns of sequence-based features that can provide a good basis for automatic prioritization of candidates by machine learning. Results We examined a variety of sequence-based features and found that for many of them there are significant differences between the sets of genes known to be involved in human hereditary disease and those not known to be involved in disease. We have created an automatic classifier called PROSPECTR based on those features using the alternating decision tree algorithm which ranks genes in the order of likelihood of involvement in disease. On average, PROSPECTR enriches lists for disease genes two-fold 77% of the time, five-fold 37% of the time and twenty-fold 11% of the time. Conclusion PROSPECTR is a simple and effective way to identify genes involved in Mendelian and oligogenic disorders. It performs markedly better than the single existing sequence-based classifier on novel data. PROSPECTR could save investigators looking at large regions of interest time and effort by prioritizing positional candidate genes for mutation detection and case-control association studies.

  4. Application of risk-based methodologies to prioritize safety resources

    International Nuclear Information System (INIS)

    Rahn, F.J.; Sursock, J.P.; Hosler, J.

    1993-01-01

    The Electric Power Research Institute (EPRI) started a program entitled risk-based prioritization in 1992. The purpose of this program is to provide generic technical support to the nuclear power industry relative to its recent initiatives in the area of operations and maintenance (O ampersand M) cost control using state-of-the-art risk methods. The approach uses probabilistic risk assessment (PRA), or similar techniques, to allocate resources commensurate with the risk posed by nuclear plant operations. Specifically, those items or events that have high risk significance would receive the most attention, while those with little risk content would command fewer resources. As quantified in a companion paper,close-quote the potential O ampersand M cost reduction inherent in this approach is very large. Furthermore, risk-based methods should also lead to safety improvements. This paper outlines the way that the EPRI technical work complements the technical, policy, and regulatory initiatives taken by others in the industry and provides an example of the approach as used to prioritize motor-operated valve (MOV) testing in response to US Nuclear Regulatory Commission (NRC) Generic Letter 89-10

  5. Prioritizing ecological restoration among sites in multi-stressor landscapes.

    Science.gov (United States)

    Neeson, Thomas M; Smith, Sigrid D P; Allan, J David; McIntyre, Peter B

    2016-09-01

    Most ecosystems are impacted by multiple local and long-distance stressors, many of which interact in complex ways. We present a framework for prioritizing ecological restoration efforts among sites in multi-stressor landscapes. Using a simple model, we show that both the economic and sociopolitical costs of restoration will typically be lower at sites with a relatively small number of severe problems than at sites with numerous lesser problems. Based on these results, we propose using cumulative stress and evenness of stressor impact as complementary indices that together reflect key challenges of restoring a site to improved condition. To illustrate this approach, we analyze stressor evenness across the world's rivers and the Laurentian Great Lakes. This exploration reveals that evenness and cumulative stress are decoupled, enabling selection of sites where remediating a modest number of high-intensity stressors could substantially reduce cumulative stress. Just as species richness and species evenness are fundamental axes of biological diversity, we argue that cumulative stress and stressor evenness constitute fundamental axes for identifying restoration opportunities in multi-stressor landscapes. Our results highlight opportunities to boost restoration efficiency through strategic use of multi-stressor datasets to identify sites that maximize ecological response per stressor remediated. This prioritization framework can also be expanded to account for the feasibility of remediation and the expected societal benefits of restoration projects. © 2016 by the Ecological Society of America.

  6. Split diversity in constrained conservation prioritization using integer linear programming.

    Science.gov (United States)

    Chernomor, Olga; Minh, Bui Quang; Forest, Félix; Klaere, Steffen; Ingram, Travis; Henzinger, Monika; von Haeseler, Arndt

    2015-01-01

    Phylogenetic diversity (PD) is a measure of biodiversity based on the evolutionary history of species. Here, we discuss several optimization problems related to the use of PD, and the more general measure split diversity (SD), in conservation prioritization.Depending on the conservation goal and the information available about species, one can construct optimization routines that incorporate various conservation constraints. We demonstrate how this information can be used to select sets of species for conservation action. Specifically, we discuss the use of species' geographic distributions, the choice of candidates under economic pressure, and the use of predator-prey interactions between the species in a community to define viability constraints.Despite such optimization problems falling into the area of NP hard problems, it is possible to solve them in a reasonable amount of time using integer programming. We apply integer linear programming to a variety of models for conservation prioritization that incorporate the SD measure.We exemplarily show the results for two data sets: the Cape region of South Africa and a Caribbean coral reef community. Finally, we provide user-friendly software at http://www.cibiv.at/software/pda.

  7. Prioritization of sediment management alternatives using stochastic multicriteria acceptability analysis

    International Nuclear Information System (INIS)

    Alvarez-Guerra, Manuel; Canis, Laure; Voulvoulis, Nikolaos; Viguri, Javier R.; Linkov, Igor

    2010-01-01

    Decision-making for sediment management is a complex task that requires the consideration of temporal and spatial impacts of several remedial alternatives as well as the associated economic, social and political impact. Multicriteria decision analysis (MCDA) is becoming increasingly recognized as an important environmental management tool that can be used to support the selection of suitable remediation alternatives and prioritization of management units in space and time. This paper proposes an MCDA framework for prioritizing sediment management alternatives. This framework involves identifying of a set of feasible options, as well as defining and evaluating criteria which integrate relevant technical, economic, social and environmental aspects of remedies. The methodology allows an explicit consideration of uncertainty in criteria scores and weights by assigning probability distributions and analyzing subsequent Monte-Carlo simulations. The consideration of different stakeholder simulated values is used to assess the robustness of alternative rankings and to guide the selection of remediation options. An application of this methodology to a case study in the Bay of Santander, Spain, is presented. An assessment is conducted for the case of unknown preferences as well as for hypothetical preferences profiles for four types of stakeholders: Idealist, Politician, Environmentalist and Balanced. The results are used to visualize stakeholder positions and potential disagreements, allowing for the identification of a group of least preferred alternatives for each stakeholder. Stakeholder involvement has the potential to ease the remedy selection process during all stages of the decision-making process and to eventually remedy implementation.

  8. A risk-based approach to prioritize underground storage tanks

    International Nuclear Information System (INIS)

    Chidambariah, V.; Travis, C.C.; Trabalka, J.R.; Thomas, J.K.

    1992-01-01

    The purpose of this paper is to present a risk-based approach for rapid prioritization of low level liquid radioactive waste underground storage tanks (LLLW USTs) for possible interim corrective measures and/or ultimate closure. The ranking of LLLW USTs is needed to ensure that tanks with the greatest potential for adverse impact on the environment and human health receive top priority for further evaluation and remediation. Wastes from the LLLW USTs at the Oak Ridge National Laboratory (ORNL) were pumped out at the time the tanks were removed from service. The residual liquids and sludge contain a mixture of radionuclides and chemicals. Contaminants of concern that were identified in the liquid phase of the inactive LLLW USTs include, the radionuclides, 9O Sr, 137 Cs and 233 U and the chemicals, carbon tetrachloride, trichloroethene, tetrachloroethene, methyl ethyl ketone, mercury, lead and chromium. The risk-based approach for prioritization of the LLLW USTs is based upon three major criteria: (1) leaking characteristics of the tank; (2) location of the tanks; and (3) toxic potential of the tank contents

  9. Prioritizing Acquisition Pathways in the State Level Concept

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, Chantell L. [Los Alamos National Laboratory; Budlong-Sylvester, Kory [Los Alamos National Laboratory; Pilat, Joseph F. [Los Alamos National Laboratory

    2012-06-27

    The International Atomic Energy Agency's (IAEA) Department of Safeguards has launched a project to further develop the State-level concept for the planning, implementation, and evaluation of safeguards activities. In order to further evolve the safeguards system an emphasis is placed on integrating inspection-related activities and the State evaluation process to draw safeguards conclusions in the most efficient way. The credible implementation of acquisition pathway analysis is central to the success of the IAEA's State-level concept. NNSA's Office of Nuclear Safeguards and Security (NA-241) The Next Generation Safeguards Initiative (NGSI) is sponsoring Los Alamos National Laboratory (LANL) to produce a study that will examine the use of acquisition pathway analysis in: (1) Developing a State-specific, State-level approach (SLA) and Annual Implementation Plan (AIP); (2) Maximizing the utility of the physical model; and (3) Supporting resource allocation decisions through a pathway prioritization. To deal with the challenge of developing an effective and efficient SLA, this study looks at: (1) Prioritizing proliferation pathways based on an assessment of a State's capabilities and assumed proliferation strategies; and (2) Relevant State behavior (e.g., transparency, cooperation, etc.) while avoiding subjective judgments about States themselves. The study makes use of case studies and concrete examples in order to illustrate how new concepts and approaches will be implemented, and how they may differ from more traditional safeguards approaches.

  10. Effects of preference heterogeneity among landowners on spatial conservation prioritization.

    Science.gov (United States)

    Nielsen, Anne Sofie Elberg; Strange, Niels; Bruun, Hans Henrik; Jacobsen, Jette Bredahl

    2017-06-01

    The participation of private landowners in conservation is crucial to efficient biodiversity conservation. This is especially the case in settings where the share of private ownership is large and the economic costs associated with land acquisition are high. We used probit regression analysis and historical participation data to examine the likelihood of participation of Danish forest owners in a voluntary conservation program. We used the results to spatially predict the likelihood of participation of all forest owners in Denmark. We merged spatial data on the presence of forest, cadastral information on participation contracts, and individual-level socioeconomic information about the forest owners and their households. We included predicted participation in a probability model for species survival. Uninformed and informed (included land owner characteristics) models were then incorporated into a spatial prioritization for conservation of unmanaged forests. The choice models are based on sociodemographic data on the entire population of Danish forest owners and historical data on their participation in conservation schemes. Inclusion in the model of information on private landowners' willingness to supply land for conservation yielded at intermediate budget levels up to 30% more expected species coverage than the uninformed prioritization scheme. Our landowner-choice model provides an example of moving toward more implementable conservation planning. © 2016 Society for Conservation Biology.

  11. IMRT treatment planning based on prioritizing prescription goals

    International Nuclear Information System (INIS)

    Wilkens, Jan J; Alaly, James R; Zakarian, Konstantin; Thorstad, Wade L; Deasy, Joseph O

    2007-01-01

    Determining the 'best' optimization parameters in IMRT planning is typically a time-consuming trial-and-error process with no unambiguous termination point. Recently we and others proposed a goal-programming approach which better captures the desired prioritization of dosimetric goals. Here, individual prescription goals are addressed stepwise in their order of priority. In the first step, only the highest order goals are considered (target coverage and dose-limiting normal structures). In subsequent steps, the achievements of the previous steps are turned into hard constraints and lower priority goals are optimized, in turn, subject to higher priority constraints. So-called 'slip' factors were introduced to allow for slight, clinically acceptable violations of the constraints. Focusing on head and neck cases, we present several examples for this planning technique. The main advantages of the new optimization method are (i) its ability to generate plans that meet the clinical goals, as well as possible, without tuning any weighting factors or dose-volume constraints, and (ii) the ability to conveniently include more terms such as fluence map smoothness. Lower level goals can be optimized to the achievable limit without compromising higher order goals. The prioritized prescription-goal planning method allows for a more intuitive and human-time-efficient way of dealing with conflicting goals compared to the conventional trial-and-error method of varying weighting factors and dose-volume constraints

  12. Research prioritization of men’s health and urologic diseases

    Directory of Open Access Journals (Sweden)

    Tyler Okland

    Full Text Available ABSTRACT Objectives We sought to determine whether disease representation in the Cochrane Database of Systematic Reviews (CDSR reflects disease burden, measured by the Global Burden of Disease (GBD Study as disability-adjusted life-years (DALYs. Materials and Methods Two investigators performed independent assessment of ten men’s health and urologic diseases (MHUDs in CDSR for systematic review and protocol representation, which were compared with percentage of total 2010 DALYs for the ten conditions. Data were analyzed for correlation using Spearman rank analysis. Results Nine of ten MHUDs were represented by at least one CDSR review. There was a poor and statistically insignificant positive correlation between CDSR representation and disease burden (rho = 0.42, p = 0.23. CDSR representation was aligned with disease burden for three conditions, greater than disease burden for one condition, and less than disease burden for six conditions. Conclusions These results yield high-quality estimates to inform future research prioritization for MHUDs. While prioritization processes are complex and multi-faceted, disease burden should be strongly considered. Awareness of research priority setting has the potential to minimize research disparities on a global scale.

  13. A study on prioritizing typical women’s entrepreneur characteristics

    Directory of Open Access Journals (Sweden)

    Ebrahim Ramezani

    2014-07-01

    Full Text Available Entrepreneurship is one of the main pivot of progress and growth of every country. The spread of entrepreneurship particularly the role of women in this category has speeded up today more than any other times. Many of researchers believe that attention to women entrepreneurship plays remarkable role in soundness and safety of nation’s economy. Maybe in Iran less attention has been paid to this matter in proportion to other countries and due to various reasons, there are not many entrepreneur woman. However, employing typical entrepreneur women in various fields of productivity, industrial, commercial, social and cultural and even higher than these, in country’s political issue proves that women’s role is magnificent and in many cases they enjoy higher abilities in portion to men. In this paper, using additive ratio assessment (ARAS as a prioritizing method, eleven entrepreneur women were chosen for prioritizing criteria for measuring a typical women’s entrepreneurship characteristics. The results show that the balance between work and family among criteria are propounded as the highest weight and fulfilling different jobs simultaneously as the lowest weight.

  14. Cost-effectiveness of a repeat HIV test in pregnancy in India.

    Science.gov (United States)

    Joshi, Smita; Kulkarni, Vinay; Gangakhedkar, Raman; Mahajan, Uma; Sharma, Sushma; Shirole, Devendra; Chandhiok, Nomita

    2015-06-11

    To evaluate cost-effectiveness of second HIV test in pregnancy. Current strategy of single HIV test during pregnancy in India can miss new HIV infections acquired after the first test or those HIV infections that were missed in the first test due to a false-negative HIV test. Between August 2011 and April 2013, 9097 pregnant HIV uninfected women were offered a second HIV test near term (34 weeks or beyond) or within 4 weeks of postpartum period. A decision analysis model was used to evaluate cost-effectiveness of a second HIV test in pregnant women near term. Our key outcome measures include programme cost with addition of second HIV test in pregnant women and quality-adjusted life years (QALYs) gained. We detected 4 new HIV infections in the second test. Thus HIV incidence among pregnant women was 0.12 (95% 0.032 to 0.297) per 100 person women years (PWY). Current strategy of a single HIV test is 8.2 times costlier for less QALYs gained as compared to proposed repeat HIV testing of pregnant women who test negative during the first test. Our results warrant consideration at the national level for including a second HIV test of all pregnant women in the national programme. However prior to allocation of resources for a second HIV test in pregnancy, appropriate strategies will have to be planned for improving compliance for prevention of mother-to-child transmission of HIV and reducing loss-to-follow-up of those women detected with HIV. CTRI/2013/12/004183. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  15. Changing attitudes and beliefs towards a woman's right to protect against HIV risk in Malawi.

    Science.gov (United States)

    Fedor, Theresa M; Kohler, Hans-Peter; McMahon, James M

    2016-01-01

    Female empowerment and positive attitudes towards women's rights in sexual relationships have been found to be key elements of successful behaviour-based HIV prevention programmes. However, HIV prevention programmes that do not specifically engage with gender issues may also affect attitudes and beliefs towards women's rights within sexual relationships. Using data from the Malawi Longitudinal Study of Families and Health we compare measures of female empowerment and changing gender norms between intervention participants and non-participants. Results suggest that female intervention participants were more likely than non-participants to believe that: (1) women have more rights within sexual relationships in general and (2) women have the right to protect themselves against HIV risk (indicating possible increases in female self-efficacy in making HIV prevention decisions). Male intervention participants showed no substantial positive change in attitudes towards women's rights. These results highlight an important positive effect of HIV prevention programmes on women's attitudes towards their own rights.

  16. Interaction between HIV awareness, knowledge, safe sex practice and HIV prevalence: evidence from Botswana.

    Science.gov (United States)

    Ray, Ranjan; Sinha, Kompal

    2012-05-01

    This paper makes methodological and empirical contributions to the study of HIV in the context of Botswana, a country with high HIV prevalence. Comparable evidence is presented from India to put the Botswana results in perspective. The results point to the strong role played by affluence and education in increasing HIV knowledge, promoting safe sex and reducing HIV prevalence. The study presents African evidence on the role played by the empowerment of women in promoting safe sex practices such as condom use. The lack of significant association between HIV prevalence and safe sex practice points to the danger of HIV-infected individuals spreading the disease through multiple sex partners and unprotected sex. This danger is underlined by the finding that females with multiple sex partners are at higher risk of being infected with HIV. These results take on special policy significance in the context of Botswana, where the issue of multiple sex partners has not been adequately addressed in the programme to contain the spread of HIV.

  17. The Role HIV-Related Blame and Stigmatisation play on Risk ...

    African Journals Online (AJOL)

    AIDS to the other, they are more likely to have low risk perception, low self efficacy and unsafe sexual behaviours when the sample is sexually active. The findings have implication for policy making and HIV/AIDS prevention programmes.

  18. Life skills as a behaviour change strategy in the prevention of HIV ...

    African Journals Online (AJOL)

    2017-09-21

    Sep 21, 2017 ... aSenior Lecturer, Department of Social Work, University of South Africa, Pretoria, South ..... HIV and AIDS prevention good practice: Strategies for public ... sector of the expanded public works programme to empower women,.

  19. HIV/AIDS knowledge among adolescent sign-language users in ...

    African Journals Online (AJOL)

    , particularly sign language users, in HIV-prevention programmes. Keywords: communication, disability, disability studies, hearing impairment, qualitative research, scoping study. African Journal of AIDS Research 2010, 9(3): 307–313 ...

  20. Challenges faced by young persons living with HIV: The case of ...

    African Journals Online (AJOL)

    Challenges faced by young persons living with HIV: The case of children on the ... Journal of Social Development in Africa ... to 34 randomly selected children who were beneficiaries of an initiative called the Community Outreach Programme.

  1. The HIV/AIDS philanthropy sector: towards harmonization of resource tracking

    NARCIS (Netherlands)

    Willekens, F.J.C.; Beekink, E.

    2008-01-01

    The HIV/AIDS philanthropic sector, which supports programmes in developing countries, is diverse. Grant making organizations include foundations, public charities and the corporate sector. Foundations include private, family and community foundations. The meaning of the term foundation varies

  2. HIV-infection as a self-reported risk factor for attempted suicide in ...

    African Journals Online (AJOL)

    Cognitive deficits included problems with cognitive flexibility, concentration and memory. ... Effective management and prevention programmes should include as imperatives early diagnosis of HIV-related suicidal behaviour, recognition of underlying psychopathology, neurocognitive deficits, associated stressors, the ...

  3. Optical programmable metamaterials

    Science.gov (United States)

    Gong, Cheng; Zhang, Nan; Dai, Zijie; Liu, Weiwei

    2018-02-01

    We suggest and demonstrate the concept of optical programmable metamaterials which can configure the device's electromagnetic parameters by the programmable optical stimuli. In such metamaterials, the optical stimuli produced by a FPGA controlled light emitting diode array can switch or combine the resonance modes which are coupled in. As an example, an optical programmable metamaterial terahertz absorber is proposed. Each cell of the absorber integrates four meta-rings (asymmetric 1/4 rings) with photo-resistors connecting the critical gaps. The principle and design of the metamaterials are illustrated and the simulation results demonstrate the functionalities for programming the metamaterial absorber to change its bandwidth and resonance frequency.

  4. NNP Life Management Programmes

    International Nuclear Information System (INIS)

    Hervia Ruperez, F.

    1996-01-01

    Around the world, power station owners are increasingly concerned to optimise Plant Life Management. In response, they are setting up Life Management programmes, of more or less ambitious scope and depth. Strategic, economic and security concerns and the close link between life extension work and the improved maintenance practices that are so important today, will increase and global these programmes for monitoring and conservation or mitigation of ageing. These programmes are all based on knowledge of the precise condition of all components and population with the greatest effect on the economics and safety of the plant, and trends in changes in their condition. (Author)

  5. The European Fusion Programme

    International Nuclear Information System (INIS)

    Palumbo, D.

    1983-01-01

    The European Fusion Programme is coordinated by Euratom and represents a long term cooperative project of Member States of the European Communities in the field of fusion, designed to lead to the joint construction of prototypes. The main lines of the programme proposed for 1982 to 1986 are: (1) the continuation of a strong effort on tokamaks with emphasis on JET construction, operation and upgrading, (2) conceptual design of NET and development of the related technology, and (3) further work on two alternative magnetic confinement systems. The current status and future plans for this programme are discussed in the paper. (author)

  6. Prisoners' knowledge of HIV/AIDS and its prevention in Kerman, Islamic Republic of Iran.

    Science.gov (United States)

    Nakhaee, F H

    2002-11-01

    Knowledge of prisoners regarding HIV/AIDS in Kerman was evaluated. Analysis indicated that the sample (n = 350) of prisoners had relatively high knowledge about HIV/AIDS and its modes of transmission. However, they had a lower level of knowledge about HIV/AIDS prevention. The overall knowledge of men about AIDS was significantly lower than women. Persons aged 46 years and older and illiterate inmates had the least knowledge about modes of transmission. In addition, the knowledge of illiterate prisoners about HIV/AIDS prevention was significantly lower than others. Evaluation of attitudes and practices of prisoners and implementation of educational programmes regarding HIV/AIDS are suggested.

  7. Breaking the silence: South African HIV policies and the needs of men who have sex with men.

    Science.gov (United States)

    Rispel, Laetitia C; Metcalf, Carol A

    2009-05-01

    Although the HIV epidemic among men who have sex with men (MSM) in South Africa preceded the onset of the generalised HIV epidemic by several years, current policies and programmes focus on heterosexual transmission and mother-to-child transmission. We used an adaptation of the UNAIDS Country Harmonised Alignment Tool (CHAT) to assess whether existing HIV policies and programmes in South Africa address the needs of MSM. This covered mapping of key risk factors and epidemiology of HIV among MSM; participation of MSM in the HIV response; and an enabling environment for service provision, funding and human resources. We found that current policies and programmes are unresponsive to the needs of MSM and that epidemiologic information is lacking, in spite of policy on MSM in the National Strategic Plan. We recommend that government initiate sentinel surveillance to determine HIV prevalence among MSM, social science research on the contexts of HIV transmission among MSM, and appropriate HIV prevention and care strategies. MSM should be closely involved in the design of policies and programmes. Supportive programme development should include dedicated financial and human resources, appropriate guidelines, and improved access to and coverage of HIV prevention, treatment and care services for MSM.

  8. An action agenda for HIV and sex workers.

    Science.gov (United States)

    Beyrer, Chris; Crago, Anna-Louise; Bekker, Linda-Gail; Butler, Jenny; Shannon, Kate; Kerrigan, Deanna; Decker, Michele R; Baral, Stefan D; Poteat, Tonia; Wirtz, Andrea L; Weir, Brian W; Barré-Sinoussi, Françoise; Kazatchkine, Michel; Sidibé, Michel; Dehne, Karl-Lorenz; Boily, Marie-Claude; Strathdee, Steffanie A

    2015-01-17

    The women, men, and transgender people who sell sex globally have disproportionate risks and burdens of HIV in countries of low, middle, and high income, and in concentrated and generalised epidemic contexts. The greatest HIV burdens continue to be in African female sex workers. Worldwide, sex workers still face reduced access to needed HIV prevention, treatment, and care services. Legal environments, policies, police practices, absence of funding for research and HIV programmes, human rights violations, and stigma and discrimination continue to challenge sex workers' abilities to protect themselves, their families, and their sexual partners from HIV. These realities must change to realise the benefits of advances in HIV prevention and treatment and to achieve global control of the HIV pandemic. Effective combination prevention and treatment approaches are feasible, can be tailored for cultural competence, can be cost-saving, and can help to address the unmet needs of sex workers and their communities in ways that uphold their human rights. To address HIV in sex workers will need sustained community engagement and empowerment, continued research, political will, structural and policy reform, and innovative programmes. But such actions can and must be achieved for sex worker communities everywhere. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. HIV/AIDS in women and children in India.

    Science.gov (United States)

    Mothi, S N; Lala, M M; Tappuni, A R

    2016-04-01

    Management of HIV in India has significantly improved with many international and local programmes supporting prevention and treatment. However, there are areas in India where women and children living with HIV endure a myriad of medical, psychological and social challenges. Women in rural poor areas in India have little control over important aspects of their life. Often, they have little decision-making powers within their families on matters that affect them personally. They find themselves unable to negotiate to protect themselves from harm or risk of infection. Those who are known to have contracted HIV are reluctant to access health care for fear of discrimination and marginalization, leading to a disproportionate death rate in HIV women. India is arguably home to the largest number of orphans of the HIV epidemic. These children face an impenetrable barrier in many Indian societies and endure stigmatization. This situation encourages concealment of the disease and discourages children and their guardians from accessing available essential services. This article provides an overview of the relevant literature and presents an insight into a complex mix of issues that arise directly out of the HIV diagnosis, including the role of social attitudes in the spread of HIV, and in creating barriers to accessing care. The review identifies international programmes and local initiatives that have ensured better access to antiretroviral therapy and have led to prolonged survival and reduction in the vertical transmission of HIV in India. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Safer disclosure of HIV serostatus for women living with HIV who experience or fear violence: a systematic review.

    Science.gov (United States)

    Kennedy, Caitlin E; Haberlen, Sabina; Amin, Avni; Baggaley, Rachel; Narasimhan, Manjulaa

    2015-01-01

    Supporting individuals as they disclose their HIV serostatus may lead to a variety of individual and public health benefits. However, many women living with HIV are hesitant to disclose their HIV status due to fear of negative outcomes such as violence, abandonment, relationship dissolution and stigma. We conducted a systematic review of studies evaluating interventions to facilitate safer disclosure of HIV status for women living with HIV who experience or fear violence. Articles, conference abstracts and programme reports were included if they reported post-intervention evaluation results and were published before 1 April 2015. Searching was conducted through electronic databases for peer-reviewed articles and conference abstracts, reviewing websites of relevant organizations for grey literature, hand searching reference lists of included studies and contacting experts. Systematic methods were used for screening and data abstraction, which was conducted in duplicate. Study quality (rigor) was assessed with the Cochrane risk of bias tool. Two interventions met the inclusion criteria: the Safe Homes and Respect for Everyone cluster-randomized trial of combination HIV and intimate partner violence (IPV) services in Rakai, Uganda, and the South Africa HIV/AIDS Antenatal Post-Test Support study individual randomized trial of an enhanced counselling intervention for pregnant women undergoing HIV testing and counselling. Both programmes integrated screening for IPV into HIV testing services and trained counsellors to facilitate discussions about disclosure based on a woman's risk of violence. However, both were implemented as part of multiple-component interventions, making it impossible to isolate the impact of the safer disclosure components. The existing evidence base for interventions to facilitate safe HIV serostatus disclosure for women who experience or fear violence is limited. Development and implementation of new approaches and rigorous evaluation of safe

  11. Routine viral load monitoring in HIV-infected infants and children in low- and middle-income countries: challenges and opportunities.

    Science.gov (United States)

    Arpadi, Stephen M; Shiau, Stephanie; De Gusmao, Eduarda Pimentel; Violari, Avy

    2017-11-01

    The objective of this commentary is to review considerations for implementing routine viral load (VL) monitoring programmes for HIV-infected infants and children living in low- and middle-income countries (LMIC). Since 2013, the World Health Organization (WHO) guidelines recommend VL testing as the preferred monitoring approach for all individuals treated with ART in order to assess treatment response, detect treatment failure and determine the need to switch to a second-line regimen in a timely manner. More recently, WHO guidelines from 2016 identify HIV-infected infants and children as a priority group for routine VL monitoring. There are a number of reasons why HIV-infected infants and children should be prioritized for routine VL monitoring. Data from national VL monitoring programmes as well as systematic reviews and meta-analyses from LMIC indicate rates of viral suppression are lower for infants and children compared to adults. The number of antiretroviral drugs and palatable formulations suitable for young children are limited. In addition, emotional and developmental issues particular to children can make daily medication administration difficult and pose a challenge to adherence and achievement of sustained viral suppression. VL monitoring can be instrumental for identifying those in need of additional adherence support, reducing regimen switches and preserving treatment options. The needs of infants and children warrant consideration in all aspects of VL monitoring services. If capacity for paediatric venipuncture is not assured, platforms that accept dried blood spot specimens are necessary in order for infants and children to have equitable access. Healthcare systems also need to prepare to manage the substantial number of infants and children identified with elevated VL, including adherence interventions that are appropriate for children. Establishing robust systems to evaluate processes and outcomes of routine VL monitoring services and to support

  12. Fellows, Associates & Students Programmes

    CERN Document Server

    2005-01-01

    The present document reviews the CERN Fellows, Associates and Students Programmes emphasizing the developments since 2000, when the previous review was presented to the Scientific Policy Committee, Finance Committee and Council (CERN/2325), and makes proposals for the coming five years. In summary, it is proposed to â?¢ Simplify the payment scheme for the Paid Scientific Associates Programme, which will no longer depend on candidateâ??s home support and age; â?¢ Broaden the scope of the Fellowship Programme, in order to facilitate the recruitment of young graduates in computing and engineering. Age-related eligibility conditions and payment levels will be replaced with experience-based criteria; â?¢ Modify subsistence rates for the Doctoral and Technical Student Programme in order to harmonize CERNâ??s payment levels with those offered by other research establishments. This document is presented for discussion and recommendation by the Scientific Policy Committee and approval by the Council. Additiona...

  13. The French nuclear programme

    International Nuclear Information System (INIS)

    Bacher, Pierre

    1987-01-01

    France has a civil nuclear power generation programme second only to the USA with 49 nuclear units in operation and 13 under construction. The units in service are described. These include 33 PWR 900 MW and 9 PWR 1300 MW units. The electricity consumption and generation in France is illustrated. The absence of a powerful anti-nuclear lobby and two main technical options have contributed to the success of the French nuclear programme. These are the PWR design and the plant standardization policy which allows the setting up of an effective industrial complex (eg for analysis of operating conditions and of safety and reliability information). The programme and the reasons for its success are reviewed. Research programmes and future plans are also discussed. (UK)

  14. Elukestva õppe programm : Erasmus+

    Index Scriptorium Estoniae

    2014-01-01

    Erasmus+ programm liidab senised koostööprogrammid „Euroopa elukestva õppe programm“, „Euroopa Noored“ ning Euroopa komisjoni rahvusvahelised kõrgharidusprogrammid. Elukestva õppe programmi 2013 kokkuvõte

  15. Greek Teachers Programme 2015

    CERN Multimedia

    Hoch, Michael

    2015-01-01

    The 3rd edition of this year's Greek Teachers Programme was co-organized by CERN Education Group and the Hellenic Physical Society and took place from 8 to 12 November 2015. The programme targets physics high-school teachers from all over Greece. It aims to help teachers inspire the next generation of scientists and engineers by motivating their students to understand and appreciate how science works at the world's largest physics laboratory, whereby increasing their interest in pursuing studies in STEM fields in secondary and post-secondary education. 33 teachers took part in this programme which comprised lectures by Greek members of the CERN scientific community, with visits to experimental facilities, hands-on activities and dedicated sessions on effective and creative ways through which participants may bring physics, particle physics and CERN closer to their school classroom. In 2015, more than 100 teachers took part in the three editions of the Greek Teachers Programme.

  16. The French energy programme

    International Nuclear Information System (INIS)

    Bohnen, U.

    1980-01-01

    The challenge of the oil crisis made French energy policy react chiefly by means of a programme for the rapid expansion of nuclear energy which has become unparalleled because of its systematic realization. The following article gives a survey of this programme and its political preconditions. The French energy programme deserves special attention as the utilization of nuclear energy in France including all related activities has reached a more advanced stage than in most other countries. The effects and requirements connected with such an extensive programme which can therefore be investigated with the help of the French example migth be of importance also for other countries in a similar way. (orig./UA) [de

  17. The Gold Standard Programme

    DEFF Research Database (Denmark)

    Neumann, Tim; Rasmussen, Mette; Ghith, Nermin

    2013-01-01

    To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates.......To evaluate the real-life effect of an evidence-based Gold Standard Programme (GSP) for smoking cessation interventions in disadvantaged patients and to identify modifiable factors that consistently produce the highest abstinence rates....

  18. Motivation programmes of organizations

    OpenAIRE

    Pízová, Tereza

    2008-01-01

    The Bachelor Thesis "'Motivation Programmes of Organizations" focuses on an extremely important area within personnel management. Employee motivation is crucial to the effective operation of businesses. Motivation programmes assist in increasing and maintaining employee motivation and demonstrate an organization's interest in its employees. This piece is on one hand concerned with theoretical foundations of motivation, describing theories and concepts important to the area of human behaviour ...

  19. A concern-based method to prioritize spill response activities

    International Nuclear Information System (INIS)

    Lamarche, A.; Bart, H.

    2002-01-01

    The Shoreline Cleanup Assessment Team (SCAT) of the Emergencies Division of Environment Canada in the Ontario Region developed a computerized method to help rank segments of shoreline according to levels of concern in the event of an oil spill. The original SCAT approach was designed to allow survey teams to acquire information about the state of shoreline spills so that assessments of oilings would be comparable in time and space. The SCAT method, which allows several decision makers to obtain an unbiased evaluation of the oiling situation, has been recognized in both Canada and the United States as a method that ensures the consistency of data gathering and processing for prioritization purposes. The concern-based prioritization system was integrated within the computerized response tools used by the SCAT team using tools such as the Great Lakes Electronic Environmental Sensitivities Atlas (GLEESA), a geographic information system (GIS) of environmental data, and Shore Assess, a GIS based computerized system used to provide support during a response phase of a spill. It was noted that this method is considered to be a practical response tool designed around the principles of performance support and cybernetics to help decision makers set priorities. It is not designed for pre-impact assessment. Instead, it ensures that existing knowledge of the spill characteristics and environmental conditions are used in a consistent and logical method to prioritize contingency plans. The factors used to evaluate concern for oiling, shoreline type and land use were described. Factors for concern assessment of biological organisms include the status of organisms as being either endangered, threatened, vulnerable, special concern, or not at risk. Characteristics of the species, potential effect of the pollutant and potential effect from response activities are other factors for concern. The method evaluates the concern for every category using a simple algorithm which is

  20. Get Tested for HIV

    Science.gov (United States)

    ... AIDS: What is HIV/AIDS? Women and HIV/AIDS Next section ... Tested? Why do I need to get tested for HIV? The only way to know if you have HIV is to get tested. Many people with HIV don’t have any symptoms. In the United States, about 1 in 7 ...

  1. A paediatric and perinatal HIV/AIDS leadership initiative in Kingston, Jamaica.

    Science.gov (United States)

    Christie, C D C

    2004-10-01

    In Jamaica 1-2% of pregnant women are HIV-positive; 876 HIV-positive pregnant women will deliver and at least 283 newly infected HIV-infected infants will be born in 2003; HIV/AIDS is the leading cause of death in children aged one to four years. We describe a collaborative "Town and Gown" programme to address the paediatric and perinatal HIV epidemic in Kingston. A team of academic and government healthcare personnel, comprising paediatricians, obstetricians, public health practitioners, nurses, microbiologists, data management and information technology personnel collaborated to address this public health emergency. A five-point plan was implemented This comprised leadership and training of a core group of paediatric/perinatal HIVprofessionals to serve Greater Kingston and St Catherine and be a model for the rest of Jamaica. Mother-to-child transmission of HIV/AIDS is prevented by counselling and HIV-testing women in the antenatal clinics, giving azidothymidine (AZT) to HIV pregnant women beginning at 28 weeks gestation, throughout labour and to the HIV-exposed infants for the first six weeks of life. A unified parallel programme for identifying the HIV-infected infant and delivering paediatric HIV care at the major paediatric centres was implemented In three years, over 30,000 pregnant women are being tested for HIV; 600 HIV-exposed babies are being identified and about 140 paediatric HIV infections will be prevented The team is building research capacity which emphasizes a strong outcomes-based research agenda and implementation of clinical trials. We are collaborating, locally, regionally and internationally. Collaboratively, the mission of reducing mother-to-child transmission of HIV/AIDS and improving the quality of life for those already living and affected by HIV/AIDS can be achieved.

  2. Sustainability as the key to prioritize investments in public infrastructures

    International Nuclear Information System (INIS)

    Pardo-Bosch, Francesc; Aguado, Antonio

    2016-01-01

    Infrastructure construction, one of the biggest driving forces of the economy nowadays, requires a huge analysis and clear transparency to decide what projects have to be executed with the few resources available. With the aim to provide the public administrations a tool with which they can make their decisions easier, the Sustainability Index of Infrastructure Projects (SIIP) has been defined, with a multi-criteria decision system called MIVES, in order to classify non-uniform investments. This index evaluates, in two inseparable stages, the contribution to the sustainable development of each infrastructure project, analyzing its social, environmental and economic impact. The result of the SIIP allows to decide the order with which projects will be prioritized. The case of study developed proves the adaptability and utility of this tool for the ordinary budget management.

  3. Sustainability as the key to prioritize investments in public infrastructures

    Energy Technology Data Exchange (ETDEWEB)

    Pardo-Bosch, Francesc, E-mail: francesc.pardo@upc.edu [Departament d' Enginyeria Civil i Ambiental, Universitat Politècnica de Catalunya - Barcelona Tech. (Spain); Political Science Department, University of California - Berkeley (United States); Aguado, Antonio, E-mail: antonio.aguado@upc.edu [Departament d' Enginyeria Civil i Ambiental, Universitat Politècnica de Catalunya - Barcelona Tech. (Spain)

    2016-09-15

    Infrastructure construction, one of the biggest driving forces of the economy nowadays, requires a huge analysis and clear transparency to decide what projects have to be executed with the few resources available. With the aim to provide the public administrations a tool with which they can make their decisions easier, the Sustainability Index of Infrastructure Projects (SIIP) has been defined, with a multi-criteria decision system called MIVES, in order to classify non-uniform investments. This index evaluates, in two inseparable stages, the contribution to the sustainable development of each infrastructure project, analyzing its social, environmental and economic impact. The result of the SIIP allows to decide the order with which projects will be prioritized. The case of study developed proves the adaptability and utility of this tool for the ordinary budget management.

  4. Prioritizing Signaling Information Transmission in Next Generation Networks

    Directory of Open Access Journals (Sweden)

    Jasmina Baraković

    2011-01-01

    Full Text Available Next generation transport network is characterized by the use of in-band signaling, where Internet Protocol (IP packets carrying signaling or media information are mixed in transmission. Since transport resources are limited, when any segment of access or core network is congested, IP packets carrying signaling information may be discarded. As a consequence, it may be impossible to implement reachability and quality of service (QoS. Since present approaches are insufficient to completely address this problem, a novel approach is proposed, which is based on prioritizing signaling information transmission. To proof the concept, a simulation study was performed using Network Simulator version 2 (ns-2 and independently developed Session Initiation Protocol (SIP module. The obtained results were statistically processed using Statistical Package for the Social Sciences (SPSS version 15.0. Summarizing our research results, several issues are identified for future work.

  5. Task-relevant information is prioritized in spatiotemporal contextual cueing.

    Science.gov (United States)

    Higuchi, Yoko; Ueda, Yoshiyuki; Ogawa, Hirokazu; Saiki, Jun

    2016-11-01

    Implicit learning of visual contexts facilitates search performance-a phenomenon known as contextual cueing; however, little is known about contextual cueing under situations in which multidimensional regularities exist simultaneously. In everyday vision, different information, such as object identity and location, appears simultaneously and interacts with each other. We tested the hypothesis that, in contextual cueing, when multiple regularities are present, the regularities that are most relevant to our behavioral goals would be prioritized. Previous studies of contextual cueing have commonly used the visual search paradigm. However, this paradigm is not suitable for directing participants' attention to a particular regularity. Therefore, we developed a new paradigm, the "spatiotemporal contextual cueing paradigm," and manipulated task-relevant and task-irrelevant regularities. In four experiments, we demonstrated that task-relevant regularities were more responsible for search facilitation than task-irrelevant regularities. This finding suggests our visual behavior is focused on regularities that are relevant to our current goal.

  6. Prioritization of motor operated valves based on risk importances

    International Nuclear Information System (INIS)

    Vesely, W.E.; Weidenhamer, G.H.

    1994-01-01

    The plant Probabilistic Risk Assessment (PRA) can be a potentially useful and powerful tool for helping to define an effective response to GL 89-10. The plant PRA can be used to prioritize the Motor Operated Valves (MOV) dynamic test. The plant PRA can also be used to determine test schedules for the MOVs. In order for the PRA to be validly used to respond to GL 89-10, various issues need to be validly addressed. Eleven issues are specifically identified and responses to these issues are outlined. The issues of joint MOV importance, PRA truncation, and validation of the proposed approach are specifically highlighted and more detailed response considerations are described. As in all PRA applications, sensitivity studies and uncertainty considerations should be incorporated in the PRA evaluations. 4 refs, 3 tabs

  7. Threat Prioritization Process for the Czech Security Strategy Making

    Directory of Open Access Journals (Sweden)

    Milos Balaban

    2012-06-01

    Full Text Available This article offers systematic view of a process of identification of security threats and, subsequently, their use in the making of strategic documents, notably the Security Strategy of the Czech Republic. It is not the aim of the authors to name or define such threats, but to present the process itself. It is paramount to any credible security strategy that it deals with the threat identification in the most precise fashion. The authors take reservations against the “catalogue” approach and claim the processes of prioritization and categorization to be essential for any policies derived from the security strategy, especially in times of economic need. It is also the 2011 final paper of the project “Trends, Risks, and Scenarios of the Security Developments in the World, Europe, and the Czech Republic – Impacts on the Policy and Security System of the Czech Republic” (TRS / VG20102013009.

  8. Spatially explicit prioritization of human antibiotics and antineoplastics in Europe.

    Science.gov (United States)

    Oldenkamp, Rik; Huijbregts, Mark A J; Hollander, Anne; Versporten, Ann; Goossens, Herman; Ragas, Ad M J

    2013-01-01

    This paper presents a screening tool for the location-specific prioritization of human pharmaceutical emissions in Europe, based on risk quotients for the aquatic environment and human health. The tool provides direction towards either monitoring activities or additional research. Its application is illustrated for a set of 11 human antibiotics and 7 antineoplastics. Risk quotients for the aquatic environment were highest for levofloxacin, doxycycline and ciprofloxacin, located in Northern Italy (Milan region; particularly levofloxacin) and other densely populated areas in Europe (e.g. London, Krakow and the Ruhr area). Risk quotients for human health not only depend on pharmaceutical and location, but also on behavioral characteristics, such as consumption patterns. Infants in eastern Spain that consume locally produced food and conventionally treated drinking water were predicted to run the highest risks. A limited comparison with measured concentrations in surface water showed that predicted and measured concentrations are approximately within one order of magnitude. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Place prioritization for biodiversity content using species ecological niche modeling

    Directory of Open Access Journals (Sweden)

    Víctor Sánchez-Cordero

    2005-01-01

    Full Text Available Place prioritization for biodiversity representation is essential for conservation planning, particularly in megadiverse countries where high deforestation threatens biodiversity. Given the collecting biases and uneven sampling of biological inventories, there is a need to develop robust models of species’ distributions. By modeling species’ ecological niches using point occurrence data and digitized environmental feature maps, we can predict potential and extant distributions of species in untransformed landscapes, as well as in those transformed by vegetation change (including deforestation. Such distributional predictions provide a framework for use of species as biodiversity surrogates in place prioritization procedures such as those based on rarity and complementarity. Beyond biodiversity conservation, these predictions can also be used for place prioritization for ecological restoration under current conditions and under future scenarios of habitat change (e.g., deforestation scenarios. To illustrate these points, we (1 predict distributions under current and future deforestation scenarios for the Mexican endemic mammal Dipodomys phillipsii, and show how areas for restoration may be selected; and (2 propose conservation areas by combining nonvolant mammal distributional predictions as biodiversity surrogates with place prioritization procedures, to connect decreed natural protected areas in a region holding exceptional biodiversity: the Transvolcanic Belt in central Mexico. La selección de áreas prioritarias de conservación es fundamental en la planeación sistemática de la conservación, particularmente en países de mega-diversidad, en donde la alta deforestación es una de las amenazas a la biodiversidad. Debido a los sesgos taxonómicos y geográficos de colecta de los inventarios biológicos, es indispensable generar modelos robustos de distribución de especies. Al modelar el nicho ecológico de especies usando localidades de

  10. Prioritization of natural phenomena hazards evaluations for CHG facilities

    International Nuclear Information System (INIS)

    GRAVES, C.E.

    2001-01-01

    Natural phenomena hazards (NPH) are unexpected acts of nature that pose a threat or danger to workers, the public or to the environment by potential damage to structures, systems and components (SSCs). Earthquakes, extreme winds (hurricane and tornado), flood, volcanic eruption, lightning strike, or extreme cold or heat are examples of NPH. This document outlines the method used to prioritize buildings for inspection following an NPH event and contains the priority list for CH2M HILL Hanford Group, Inc. (CHG) buildings. Once an NPH event occurs and the Hanford Emergency Operations Center (EOC) is activated, this document will be used by the EOC to assign building inspections for the trained evaluators, barring any information from the field

  11. Prioritization of R and D programs on probabilistic reactor safety

    International Nuclear Information System (INIS)

    Husseiny, A.A.

    1982-01-01

    An interactive computer code based on the multiattribute utility theory has been developed with graphic capabilities to use in selection of probabilistic reactor safety RandD programs. Utility values and proper graphic representation are made through lottery games on the computer terminal. The code is applied to prioritize a set of RandD programs on LWR safety based on attributes including regulatory issues, institutional issues and operation problems. The methodology is described here in detail with its applications. Some of the input includes statistical distributions and subjective judgments on institutional issues. The flexibility of the approach provides a tool for decision makers whether on individual or group level to assess LWR safety priorities and continuously update their strategies

  12. Prioritized Main Potential Solutions for the e-Navigation Concept

    Directory of Open Access Journals (Sweden)

    Adam Weintrit

    2013-03-01

    Full Text Available In the paper the Author, a member of the International Maritime Organization’s Correspondence Group on e-Navigation, outlines the prioritized solutions for e-Navigation concept formulated at the beginning of 2013. He presents the details of internal CG’s discussions, different national positions after the announcement by the chairman of the group, Mr John Erik Hagen, the working material in this case. The hidden purpose of this study is to show the style and pace of the IMO working group, details regarding the exchange of posts and the formation of a final common position. Author presents just three weeks working with the CG on e-Nav in the lens, doing it with the consent of all participants in this discussion.

  13. Biomedical hypothesis generation by text mining and gene prioritization.

    Science.gov (United States)

    Petric, Ingrid; Ligeti, Balazs; Gyorffy, Balazs; Pongor, Sandor

    2014-01-01

    Text mining methods can facilitate the generation of biomedical hypotheses by suggesting novel associations between diseases and genes. Previously, we developed a rare-term model called RaJoLink (Petric et al, J. Biomed. Inform. 42(2): 219-227, 2009) in which hypotheses are formulated on the basis of terms rarely associated with a target domain. Since many current medical hypotheses are formulated in terms of molecular entities and molecular mechanisms, here we extend the methodology to proteins and genes, using a standardized vocabulary as well as a gene/protein network model. The proposed enhanced RaJoLink rare-term model combines text mining and gene prioritization approaches. Its utility is illustrated by finding known as well as potential gene-disease associations in ovarian cancer using MEDLINE abstracts and the STRING database.

  14. Considerations on the selection and prioritization of information security solutions

    Directory of Open Access Journals (Sweden)

    Maria Cristina RĂDULESCU

    2016-05-01

    Full Text Available This paper provides a set of guidelines that can be used for prescribing a methodology or a detailed process for selecting and prioritizing security projects or solutions. It is based on the idea that costs of security solutions should be justified by their contribution to ensuring adequate protection of information resources in the organization which implements them. The article reviews general issues of security risks and costs, arguing the need for explicit consideration of information resources security requirements in order to validate decisions concerning security projects implementation. In such an approach, security requirements of information resources are used as a reference system to quantify the benefits and limitations of security solutions defined as alternative or complementary responses to certain security risks as their implementation faces budget constraints.

  15. Prioritizing research to reduce youth suicide and suicidal behavior.

    Science.gov (United States)

    Bridge, Jeffrey A; Horowitz, Lisa M; Fontanella, Cynthia A; Grupp-Phelan, Jackie; Campo, John V

    2014-09-01

    The goal of the National Action Alliance for Suicide Prevention is to reduce suicide and suicide attempts in the U.S. by 40% in the next decade. In this paper, a public health approach is applied to suicide prevention to illustrate how reductions in youth suicide and suicidal behavior might be achieved by prioritizing research in two areas: (1) increasing access to primary care-based behavioral health interventions for depressed youth and (2) improving continuity of care for youth who present to emergency departments after a suicide attempt. Finally, some scientific, clinical, and methodologic breakthroughs needed to achieve rapid, substantial, and sustained reductions in youth suicide and suicidal behavior are discussed. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Prioritization of natural phenomena hazards evaluations for CHG facilities

    CERN Document Server

    Graves, C E

    2001-01-01

    Natural phenomena hazards (NPH) are unexpected acts of nature that pose a threat or danger to workers, the public or to the environment by potential damage to structures, systems and components (SSCs). Earthquakes, extreme winds (hurricane and tornado), flood, volcanic eruption, lightning strike, or extreme cold or heat are examples of NPH. This document outlines the method used to prioritize buildings for inspection following an NPH event and contains the priority list for CH2M HILL Hanford Group, Inc. (CHG) buildings. Once an NPH event occurs and the Hanford Emergency Operations Center (EOC) is activated, this document will be used by the EOC to assign building inspections for the trained evaluators, barring any information from the field.

  17. The WHO AFRO external quality assessment programme (EQAP: Linking laboratory networks through EQA programmes

    Directory of Open Access Journals (Sweden)

    Debrah I. Boeras

    2016-10-01

    Full Text Available External Quality Assessment (EQA surveys performed by the World Health Organization Regional Office for Africa (WHO AFRO revealed the need for the strengthening of publichealth microbiology laboratories, particularly for testing of epidemic-prone diseases in theAfrican Region. These surveys revealed common issues such as supply chain managementskilled personnel, logistical support and overall lack of quality standards. For sustainableimprovements to health systems as well as global health security, deficiencies identified needto be actively corrected through robust quality assurance programmes and implementation oflaboratory quality management systems. Given all the pathogens of public health importance, an external quality assessment programmewith a focus on vaccine-preventable diseases and emerging and re-emerging dangerouspathogens is important, and should not be stand-alone, but integrated within laboratorynetworks as seen in polio, measles, yellow fever and rubella. In 2015, WHO AFRO collaborated with the US Centers for Disease Control and Preventionthe London School of Hygiene & Tropical Medicine and partners in a series of consultationswith countries and national and regional EQA providers for the development of qualityassurance models to support HIV point-of-care testing and monitoring. These consultationsrevealed similar challenges as seen in the WHO AFRO surveys. WHO AFRO brought forthits experience in implementing quality standards for health programmes, and also openeddiscussions on how lessons learned through such established programmes can be utilised tosupporting and strengthening the introduction of early infant diagnosis of HIV and viralload point-of-care testing. An optimised external quality assessment programme will impact the ability of countries tomeet core capacities, providing improved quality management systems, improving theconfidence of diagnostic network services in Africa, and including capacities to detect eventsof

  18. Fear and Guilt in HIV and AIDS Prevention | Gwandure | Africa Insight

    African Journals Online (AJOL)

    The social learning theory concepts of fear and guilt are regarded as inhibitory factors in disease prevention, and this article examines the possibility of incorporating fear and guilt training courses into HIV and AIDS prevention programmes. HIV and AIDS educators could help participants understand the role of fear and guilt ...

  19. A Survey of Plants with Anti-HIV Active Compounds and their Modes ...

    African Journals Online (AJOL)

    Background: Several limitations of current antiretroviral therapy (ART) programmes will continue to push patients towards the use of plants to manage HIV/AIDS. However, evidence about the use of anti-HIV plants is anecdotal. Objectives: Search the literature for research articles that document plants with anti-HIV ...

  20. Gender Issues in STIs/HIV/AIDS Prevention and Control: The Case ...

    African Journals Online (AJOL)

    Commercial sex workers are the second target group benefiting from special programmes designed to address their particular needs in STIs/HIV/AIDS prevention and control. By targeting male workers and commercial sex workers, the agencies have failed to address married women's issues in STIs/HIV/AIDS prevention ...

  1. Life skills training as HIV/AIDS preventive strategy in secondary ...

    African Journals Online (AJOL)

    A life skills and HIV/AIDS education programme was implemented in secondary schools as a strategy to combat the spread of HIV/AIDS among school-going young people in South Africa. As part of a joint effort of the Departments of Health and Education, two teachers per school were trained to implement life skills training ...

  2. The relation of HIV testing and treatment to identity formation in ...

    African Journals Online (AJOL)

    This is embodied in the deep-rooted suspicion that many Zambians have toward the international HIV/AIDS-response sector from which HIV and AIDS treatment programmes are derived. Drawing upon the notion of 'therapeutic citizenship' I examine why the 'AIDS industry' continues to symbolise such tension. I explore how ...

  3. Antenatal screening for HIV, hepatitis B and syphilis in the Netherlands is effective

    NARCIS (Netherlands)

    Coul, E.L.M. op de; Hahné, S.; Weert, Y.M. van; Oomen, P.; Smit, S.; Ploeg, C.P.B. van der; Notermans, D.W.; Boer, K.; Sande1, M.A.B. van der

    2011-01-01

    A screening programme for pregnant women has been in place since the 1950s in the Netherlands. In 2004 universal HIV screening according to opting out was implemented. Here, we describe the evaluation of the effectiveness of antenatal screening in the Netherlands for 2006-2008 for HIV, hepatitis B

  4. Antenatal screening for HIV, hepatitis B and syphilis in the Netherlands is effective

    NARCIS (Netherlands)

    op de Coul, E.L.M.; Hahne, S.; van Weert, Y.W.M.; Oomen, P.; Smit, C.; van der Ploeg, K.P.B.; Notermans, D.W.; Boer, K.; van der Sande, M.A.B.

    2011-01-01

    Background: A screening programme for pregnant women has been in place since the 1950s in the Netherlands. In 2004 universal HIV screening according to opting out was implemented. Here, we describe the evaluation of the effectiveness of antenatal screening in the Netherlands for 2006-2008 for HIV,

  5. A comparison of the clinical features of depression in hiv-positive ...

    African Journals Online (AJOL)

    by far the worst affected region in the world with a continental prevalence of around ... This study compared the clinical features of major depression between .... programme Statistical Package for Social Scientists (SPSS), version 11.5. ... HIV-Positive N=64 n(%) HIV-Negative N=66 n(%) X2. OR (95%CI). P-Value. Gender.

  6. Carletonville-Mothusimpilo project: limiting transmission of HIV through community-based interventions

    CSIR Research Space (South Africa)

    Williams, BG

    2000-06-01

    Full Text Available at the start of the epidemic, contributed to the spread of HIV in Carletonville, the largest gold-mining complex in the world. We first consider the political and economic context within which earlier attempts to develop HIV intervention programmes were made...

  7. The health literacy needs of women living with HIV/AIDS | Thompson ...

    African Journals Online (AJOL)

    Women in Sub-Saharan Africa are disproportionately affected by the virus and constitute 60% of the total HIV/AIDS infections in this region. Current recommendations endorse the involvement of people living with HIV in the development of programmes for people living with the virus. The purpose of the study was to explore ...

  8. Attribution patterns, attitude and knowledge of Hiv/Aids on sexual ...

    African Journals Online (AJOL)

    Sexual behavioural change is central to HIV/AIDS control programme. This study was carried out among students (n = 603; average age = 18.9) of Covenant University, Nigeria. The study was designed to examine the impact of attribution patterns, attitude and knowledge of HIV/AIDS on sexual behavioural change.

  9. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... of HIV in the United States, please visit: https://www.aids.gov/hiv-aids-basics/hiv-aids- ... HIV, STD, and TB Prevention. About HIV/AIDS. ( https://www.cdc.gov/actagainstaids/basics/whatishiv.html ). Atlanta, ...

  10. A methodology for comprehensive strategic planning and program prioritization

    Science.gov (United States)

    Raczynski, Christopher Michael

    2008-10-01

    This process developed in this work, Strategy Optimization for the Allocation of Resources (SOAR), is a strategic planning methodology based off Integrated Product and Process Development and systems engineering techniques. Utilizing a top down approach, the process starts with the creation of the organization vision and its measures of effectiveness. These measures are prioritized based on their application to external world scenarios which will frame the future. The programs which will be used to accomplish this vision are identified by decomposing the problem. Information is gathered on the programs as to the application, cost, schedule, risk, and other pertinent information. The relationships between the levels of the hierarchy are mapped utilizing subject matter experts. These connections are then utilized to determine the overall benefit of the programs to the vision of the organization. Through a Multi-Objective Genetic Algorithm a tradespace of potential program portfolios can be created amongst which the decision maker can allocate resources. The information and portfolios are presented to the decision maker through the use of a Decision Support System which collects and visualizes all the data in a single location. This methodology was tested utilizing a science and technology planning exercise conducted by the United States Navy. A thorough decomposition was defined and technology programs identified which had the potential to provide benefit to the vision. The prioritization of the top level capabilities was performed through the use of a rank ordering scheme and a previous naval application was used to demonstrate a cumulative voting scheme. Voting was performed utilizing the Nominal Group Technique to capture the relationships between the levels of the hierarchy. Interrelationships between the technologies were identified and a MOGA was utilized to optimize portfolios with respect to these constraints and information was placed in a DSS. This

  11. Rolling out Xpert MTB/RIF® for tuberculosis detection in HIV-positive populations: An opportunity for systems strengthening

    Directory of Open Access Journals (Sweden)

    Ishani Pathmanathan

    2017-03-01

    Conclusion: Xpert MTB/RIF will only improve patient outcomes if optimally implemented within the context of strong tuberculosis programmes and systems. Roll-out of this technology to people living with HIV and others in resource-limited settings offers the opportunity to leverage current tuberculosis and HIV laboratory, diagnostic and programmatic investments, while also addressing challenges and strengthening coordination between laboratory systems, laboratory-programme interfaces, and tuberculosis-HIV programme interfaces. If successful, the benefits of this tool could extend beyond progress toward global End TB Strategy goals, to improve system-wide capacity for global disease detection and control.

  12. Acceptability of HIV/AIDS testing among pre-marital couples in Iran (2012)

    OpenAIRE

    Ayatollahi, Jamshid; Nasab Sarab, Mohammad Ali Bagheri; Sharifi, Mohammad Reza; Shahcheraghi, Seyed Hossein

    2014-01-01

    Background: Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) is a lifestyle-related disease. This disease is transmitted through unprotected sex, contaminated needles, infected blood transfusion and from mother to child during pregnancy and delivery. Prevention of infection with HIV, mainly through safe sex and needle exchange programmes is a solution to prevent the spread of the disease. Knowledge about HIV state helps to prevent and subsequently reduce the harm ...

  13. Conspiracy Beliefs Are Not Necessarily a Barrier to Engagement in HIV Care Among Urban, Low-Income People of Color Living with HIV.

    Science.gov (United States)

    Jaiswal, J; Singer, S N; Griffin Tomas, M; Lekas, H-M

    2018-02-27

    HIV-related "conspiracy beliefs" include ideas about the genocidal origin of HIV to target minority people, and the notion that a cure for HIV is being deliberately withheld. Previous literature suggests that these beliefs may negatively affect engagement in HIV care and ART adherence, but little is known about how people who are disengaged from care may think about these ideas. Twenty-seven semi-structured interviews were conducted with low-income Black and Latinx people living with HIV in NYC who were currently disengaged from, or recently re-engaged in, HIV care. The data suggest that HIV-related "conspiracy beliefs" are not necessarily a barrier to care. Regardless of whether or not people endorsed these ideas, participants were largely dismissive, and prioritized focusing on managing their HIV and overall health and life challenges. Interventions aiming to improve ART adherence and retention in HIV care should focus on building trust between clinicians and populations that have experienced historical, as well as ongoing, marginalization. HIV care providers should ask patients open-ended questions specifically about their beliefs about HIV and ART in order to address potential suspicion. Moving away from the phrase "conspiracy beliefs" in favor of more neutral language, such as "HIV-related beliefs," can enable us to better understand these ideas in the context of people's daily lives. Further research is needed to better understand how structural inequality may shape how people experience mistrust, and how mistrust may factor into the constellation of barriers to consistent engagement in HIV care.

  14. The INTEGRAL Core Observing Programme

    DEFF Research Database (Denmark)

    Winkler, C.; Gehrels, N.; Lund, Niels

    1999-01-01

    The Core Programme of the INTEGRAL mission is defined as the portion of the scientific programme covering the guaranteed time observations for the INTEGRAL Science Working Team. This paper describes the current status of the Core Programme preparations and summarizes the key elements...... of the observing programme....

  15. Asymptomatic HIV infection

    Science.gov (United States)

    ... of HIV/AIDS during which there are no symptoms of HIV infection. During this phase, the immune system in someone with HIV slowly weakens, but the person has no symptoms. How long this phase lasts depends on how ...

  16. HIV and Pulmonary Hypertension

    Science.gov (United States)

    ... What do I need to know about pulmonary hypertension in connection with HIV? Although pulmonary hypertension and ... Should an HIV patient be tested for pulmonary hypertension? HIV patients know that medical supervision is critical ...

  17. Combined approach of grey relational analysis and analytic hierarchy process for ARCAL/IAEA strategic actions prioritization

    International Nuclear Information System (INIS)

    Silva, Pedro Maffia da; Martins, Eduardo Ferraz; Rondinelli Junior, Francisco; Garcia, Pauli Adriano de Almada

    2015-01-01

    The IAEA technical cooperation (TC) programme is the main mechanism through which the IAEA delivers technical services to its Member States. Through the programme, the IAEA helps Member States to build, strengthen and maintain capacities in the safe, peaceful and secure use of nuclear technology in support of sustainable socioeconomic development. The Regional Cooperation Agreement for the Promotion of Nuclear Science and Technology in Latin America and the Caribbean (ARCAL) is a TC agreement between most IAEA member states in the Latin America and the Caribbean region for technical and economic cooperation to promote the use of nuclear techniques for peace and development. The present study aims to propose a combined approach to prioritize the needs and problems of ARCAL region. To do that, this paper considers the concept of Grey Relational Analysis and Analytic Hierarchy Process for data treatment, standardization and ranking of those needs and problems. In other words, the proposition intend to reduce the biases that may be introduced along the stage of the needs and problems assessment in the regional strategic profile formulation. (author)

  18. Combined approach of grey relational analysis and analytic hierarchy process for ARCAL/IAEA strategic actions prioritization

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Pedro Maffia da; Martins, Eduardo Ferraz; Rondinelli Junior, Francisco, E-mail: pmsilva@cnen.gov.br, E-mail: efmartins@cnen.gov.br, E-mail: rondinel@cnen.gov.br [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Garcia, Pauli Adriano de Almada, E-mail: pauliadriano@id.uff.br [Universidade Federal Fluminense (UFF), Volta Redonda, RJ (Brazil)

    2015-07-01

    The IAEA technical cooperation (TC) programme is the main mechanism through which the IAEA delivers technical services to its Member States. Through the programme, the IAEA helps Member States to build, strengthen and maintain capacities in the safe, peaceful and secure use of nuclear technology in support of sustainable socioeconomic development. The Regional Cooperation Agreement for the Promotion of Nuclear Science and Technology in Latin America and the Caribbean (ARCAL) is a TC agreement between most IAEA member states in the Latin America and the Caribbean region for technical and economic cooperation to promote the use of nuclear techniques for peace and development. The present study aims to propose a combined approach to prioritize the needs and problems of ARCAL region. To do that, this paper considers the concept of Grey Relational Analysis and Analytic Hierarchy Process for data treatment, standardization and ranking of those needs and problems. In other words, the proposition intend to reduce the biases that may be introduced along the stage of the needs and problems assessment in the regional strategic profile formulation. (author)

  19. Ethnicity and HIV risk behaviour, testing and knowledge in Guatemala.

    Science.gov (United States)

    Taylor, Tory M; Hembling, John; Bertrand, Jane T

    2015-01-01

    To describe levels of risky sexual behaviour, HIV testing and HIV knowledge among men and women in Guatemala by ethnic group and to identify adjusted associations between ethnicity and these outcomes. Data on 16,205 women aged 15-49 and 6822 men aged 15-59 from the 2008-2009 Encuesta Nacional de Salud Materno Infantil were used to describe ethnic group differences in sexual behaviour, HIV knowledge and testing. We then controlled for age, education, wealth and other socio-demographic factors in a multivariate logistic regression model to examine the effects of ethnicity on outcomes related to age at sexual debut, number of lifetime sex partners, comprehensive HIV knowledge, HIV testing and lifetime sex worker patronage (men only). The data show low levels of risky sexual behaviour and low levels of HIV knowledge among indigenous women and men, compared to other respondents. Controlling for demographic factors, indigenous women were more likely than other women never to have been tested for HIV and to lack comprehensive HIV knowledge. They were less likely to report early sexual debut and three or more lifetime sexual partners. Indigenous men were more likely than other men to lack comprehensive HIV knowledge and demonstrated lower odds of early sexual debut, 10 or more lifetime sexual partners and sex worker patronage. The Mayan indigenous population in Guatemala, while broadly socially vulnerable, does not appear to be at elevated risk for HIV based on this analysis of selected risk factors. Nonetheless, low rates of HIV knowledge and testing may be cause for concern. Programmes working in indigenous communities should focus on HIV education and reducing barriers to testing. Further research into the factors that underlie ethnic self-identity and perceived ethnicity could help clarify the relative significance of these measures for HIV risk and other health outcomes.

  20. Strategies for gender-equitable HIV services in rural India

    Science.gov (United States)

    Sinha, Gita; Peters, David H; Bollinger, Robert C

    2009-01-01

    The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt Mosley and Chen's conceptual framework of health to outline determinants for HIV health services utilization and outcomes. Examining the framework through a gender lens, we conduct a comprehensive literature review for gender-related gaps in HIV clinical services in rural India, focusing on patient access and outcomes, provider practices, and institutional partnerships. Contextualizing findings from rural India in the broader international literature, we describe potential strategies for gender-equitable HIV services in rural India, as responses to the following three questions: (1) What gender-specific patient needs should be addressed for gender-equitable HIV testing and care? (2) What do health care providers need to deliver HIV services with gender equity? (3) How should institutions enforce and sustain gender-equitable HIV services? Data at this early stage indicate substantial gender-related differences in HIV services in rural India, reflecting prevailing gender norms. Strategies including gender-specific HIV testing and care services would directly address current gender-specific patient needs. Rural care providers urgently need training in gender sensitivity and HIV-related communication and clinical skills. To enforce and sustain gender equity, multi-sectoral institutions must establish gender-equitable medical workplaces, interdisciplinary HIV services partnerships, and oversight methods, including analysis of gender-disaggregated data. A gender-equitable approach to rural India's rapidly evolving HIV services programmes could serve as a foundation for gender equity in the overall health care system. PMID:19244284

  1. Correlates of HIV Risk Reduction Self-Efficacy among Youth in South Africa

    Directory of Open Access Journals (Sweden)

    Julia Louw

    2012-01-01

    Full Text Available Even though a decline in HIV prevalence has been reported among South African youth 15–24 from 10.3% in 2005 to 8.6% in 2008, the prevalence remains disproportionately high for females overall in comparison to males. This study examines factors associated by HIV risk reduction self-efficacy of South African youth as part of an evaluation of the impact of loveLife, a youth focused HIV prevention programme. A cross-sectional population-based household survey was conducted with persons of ages 18 to 24 years in four selected provinces in South Africa. Among female respondents (, factors associated with high self-efficacy in the adjusted model were having a low HIV risk perception, HIV/AIDS stigma, ever using drugs, and having life goals. Male respondents ( with high self-efficacy were more likely to have been tested for HIV, have concurrent sexual partners, have had a transactional sex partner in lifetime, a low HIV risk perception, difficulty in having condoms, agreed with coercive sex, high relationship control, and had loveLife face-to-face programme participation. The factors identified with high self-efficacy and HIV-sexual risk behaviour may be considered to strengthen youth HIV prevention programmes in South Africa.

  2. Implementing HIV/AIDS education: impact of teachers' training on HIV/AIDS education in Bangladesh.

    Science.gov (United States)

    Sarma, Haribondhu; Oliveras, Elizabeth

    2013-03-01

    School-based HIV/AIDS education is a common and well-proven intervention strategy for providing information on HIV/AIDS to young people. However, lack of skills among teachers for imparting sensitive information to students can lead to programme failure in terms of achieving goals. A cross-sectional study was conducted among teachers to identify the factors that support or hinder their role in HIV/AIDS education. A self-administered questionnaire was used for interviewing teachers from randomly-selected schools in two adjacent districts in Bangladesh. Based on exposure to teachers' training, the districts were divided into control and intervention areas and the teachers' ability, skill, and their participation in HIV/AIDS education were compared between the districts. Trained teachers in the intervention schools were more likely to participate, less likely to face difficulties, and more likely to use interactive teaching methods in HIV/ AIDS classes compared to the controls who did not receive any training. Inadequate allocation of time for conducting the HIV/AIDS class was found to be barriers to HIV/AIDS education that suggest the need to provide teachers with more support in terms of training and logistics.

  3. ExpoCast: Exposure Science for Prioritization and Toxicity Testing (S)

    Science.gov (United States)

    The US EPA is completing the Phase I pilot for a chemical prioritization research program, called ToxCast. Here EPA is developing methods for using computational chemistry, high-throughput screening, and toxicogenomic technologies to predict potential toxicity and prioritize limi...

  4. The Effect of a Workload-Preview on Task-Prioritization and Task-Performance

    Science.gov (United States)

    Minotra, Dev

    2012-01-01

    With increased volume and sophistication of cyber attacks in recent years, maintaining situation awareness and effective task-prioritization strategy is critical to the task of cybersecurity analysts. However, high levels of mental-workload associated with the task of cybersecurity analyst's limits their ability to prioritize tasks.…

  5. Arts and Humanities Research, Redefining Public Benefit, and Research Prioritization in Ireland

    Science.gov (United States)

    Gibson, Andrew G.; Hazelkorn, Ellen

    2017-01-01

    This article looks at the effects of a national policy of research prioritization in the years following Ireland's economic crisis. A national research prioritization exercise initiated by policymakers redefined the purpose of higher education research, and designed policies in line with this approach. Placing research for enterprise to the fore,…

  6. Non-communicable diseases and HIV care and treatment: models of integrated service delivery.

    Science.gov (United States)

    Duffy, Malia; Ojikutu, Bisola; Andrian, Soa; Sohng, Elaine; Minior, Thomas; Hirschhorn, Lisa R

    2017-08-01

    Non-communicable diseases (NCD) are a growing cause of morbidity in low-income countries including in people living with human immunodeficiency virus (HIV). Integration of NCD and HIV services can build upon experience with chronic care models from HIV programmes. We describe models of NCD and HIV integration, challenges and lessons learned. A literature review of published articles on integrated NCD and HIV programs in low-income countries and key informant interviews were conducted with leaders of identified integrated NCD and HIV programs. Information was synthesised to identify models of NCD and HIV service delivery integration. Three models of integration were identified as follows: NCD services integrated into centres originally providing HIV care; HIV care integrated into primary health care (PHC) already offering NCD services; and simultaneous introduction of integrated HIV and NCD services. Major challenges identified included NCD supply chain, human resources, referral systems, patient education, stigma, patient records and monitoring and evaluation. The range of HIV and NCD services varied widely within and across models. Regardless of model of integration, leveraging experience from HIV care models and adapting existing systems and tools is a feasible method to provide efficient care and treatment for the growing numbers of patients with NCDs. Operational research should be conducted to further study how successful models of HIV and NCD integration can be expanded in scope and scaled-up by managers and policymakers seeking to address all the chronic care needs of their patients. © 2017 John Wiley & Sons Ltd.

  7. The French nuclear programme

    International Nuclear Information System (INIS)

    Feger, M.

    1990-01-01

    EDF has long been interested in the use of nuclear energy for thermal power generation. After a period of apprenticeship and experiments, EDF launched a major PWR plant programme so as to reduce France's energy dependence and master generation costs. This programme, based on standardization, has achieved the desired results. It must now be adapted to suit the needs of the 21st century. For this programme, all those involved (Governmental authorities, EDF, manufacturers) were mobilized to an unprecedented extent and rigorous working methods were imposed. Experience feedback has been used to make improvements both to the installations themselves and to procedures. Results have proved satisfactory as regards nuclear safety but vigilance must be maintained. Public opinion on nuclear power is reserved we are sentenced to achieving a 'fault-free' track record, all the while mastering costs, so as to ensure the continuing use of nuclear energy. (author)

  8. The French nuclear programme

    Energy Technology Data Exchange (ETDEWEB)

    Feger, M [Ecole Nationale Superieure d' Electrotechnique de Grenoble, Institute National des Sciences et Techniques Nucleaires (Saclay), Gif-sur-Yvette, Electricite de France (France)

    1990-06-01

    EDF has long been interested in the use of nuclear energy for thermal power generation. After a period of apprenticeship and experiments, EDF launched a major PWR plant programme so as to reduce France's energy dependence and master generation costs. This programme, based on standardization, has achieved the desired results. It must now be adapted to suit the needs of the 21st century. For this programme, all those involved (Governmental authorities, EDF, manufacturers) were mobilized to an unprecedented extent and rigorous working methods were imposed. Experience feedback has been used to make improvements both to the installations themselves and to procedures. Results have proved satisfactory as regards nuclear safety but vigilance must be maintained. Public opinion on nuclear power is reserved we are sentenced to achieving a 'fault-free' track record, all the while mastering costs, so as to ensure the continuing use of nuclear energy. (author)

  9. External Mobility Programme

    CERN Multimedia

    HR Department

    2007-01-01

    Every year, a significant number of highly-skilled staff members leave the Organization and offer their talents on the European job market. CERN is launching a programme aiming to help staff members to whom the Organization cannot offer an indefinite contract in the transition towards their next employment. The programme, which is based on the establishment of a number of partnerships with potential employers in the private sector, will run on a voluntary basis. Staff members who have received confirmation that they will not be offered an indefinite contract and who are interested in availing themselves of the opportunities offered by the programme, are invited to enrol by following the procedure described at: https://ert.cern.ch/browse_intranet/wd_pds?p_web_page_id=5841 Applications will be processed in the strictest confidence by the Human Resources Department and eligible profiles will then be made available to partner companies for recruitment purposes. Any subsequent ...

  10. Resourcing resilience: social protection for HIV prevention amongst children and adolescents in Eastern and Southern Africa.

    Science.gov (United States)

    Toska, Elona; Gittings, Lesley; Hodes, Rebecca; Cluver, Lucie D; Govender, Kaymarlin; Chademana, K Emma; Gutiérrez, Vincent Evans

    2016-07-01

    Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with behavioural and social interventions to alleviate the socio-structural determinants of HIV infection. There is growing evidence that social protection has the potential to reduce the risk of HIV infection among children and adolescents. This research combined expert consultations with a rigorous review of academic and policy literature on the effectiveness of social protection for HIV prevention among children and adolescents, including prevention for those already HIV-positive. The study had three goals: (i) assess the evidence on the effectiveness of social protection for HIV prevention, (ii) consider key challenges to implementing social protection programmes that promote HIV prevention, and (iii) identify critical research gaps in social protection and HIV prevention, in Eastern and Southern Africa. Causal pathways of inequality, poverty, gender and HIV risk require flexible and responsive social protection mechanisms. Results confirmed that HIV-inclusive child-and adolescent-sensitive social protection has the potential to interrupt risk pathways to HIV infection and foster resilience. In particular, empirical evidence (literature and expert feedback) detailed the effectiveness of combination social protection particularly cash/in-kind components combined with "care" and "capability" among children and adolescents. Social protection programmes should be dynamic and flexible, and consider age, gender, HIV-related stigma, and context, including cultural norms, which offer opportunities to improve programmatic coverage, reach and uptake. Effective HIV prevention also requires integrated social protection policies, developed through strong national

  11. Mapping structural influences on sex and HIV education in church and secular schools in Zimbabwe.

    Science.gov (United States)

    Mpofu, Elias; Mutepfa, Magen Mhaka; Hallfors, Denise Dion

    2012-09-01

    The authors used state-of-the-art concept mapping approaches to examine structural institutional effects of church and secular high schools on the types of sexual and HIV-prevention education messages transmitted to learners in Zimbabwe. Participants were school teachers (n = 26), school counselors (n = 28), and pastors involved in student pastoral care (n = 14; males = 27, females = 41). They reported on messages perceived to influence sexual decisions of learners in their school setting. The self-report data were clustered into message types using concept mapping and contrasted for consistency of content and structure both between and within type of school. The authors also engaged in curriculum document study with member checks in the participant schools to determine convergence of the evidence on school-type effects of the messages transmitted to students. Church schools prioritized faith-informed sexual and HIV-prevention messages, whereas both types of schools prioritized Life skills education and a future focus. Secular schools prioritized sex and HIV messages in the context of community norms. Facts about HIV and AIDS were relatively underemphasized by church schools. The implicit knowledge values that differentiate types of schools influence learner access to information important for their sexual decisions.

  12. An inappropriate tool: criminal law and HIV in Asia.

    Science.gov (United States)

    Csete, Joanne; Dube, Siddharth

    2010-09-01

    Asian countries have applied criminal sanctions widely in areas directly relevant to national HIV programmes and policies, including criminalization of HIV transmission, sex work, homosexuality and drug injection. This criminalization may impede universal access to HIV prevention and treatment services in Asia and undermine vulnerable people's ability to be part of the HIV response. To review the status of application of criminal law in key HIV-related areas in Asia and analyze its impact. Review of literature and application of human rights norms to analysis of criminal law measures. Criminal laws in the areas considered here and their enforcement, while intended to reduce HIV transmission, are inappropriate and counterproductive with respect to health and human rights. Governments should remove punitive laws that impede the HIV response and should ensure meaningful participation of people living with HIV, people who use illicit drugs, sex workers and men who have sex with men in combating stigma and discrimination and developing rights-centered approaches to HIV.

  13. Representations of HIV/AIDS management in South African newspapers.

    Science.gov (United States)

    Campbell, Catherine; Gibbs, Andy

    2008-07-01

    In South Africa, numerous strong policy statements emphasise the importance of involving communities in HIV/AIDS management, yet in practice such involvement tends to be tokenistic and minimal. Social representations in the public sphere constitute the symbolic dimension within which responses to HIV and AIDS are conceptualised and transformed into action. Through an analysis of newspaper articles, we explore the dominant representations of HIV/AIDS management circulating in the South African public sphere and examine how community engagement is depicted. We highlight the way media representations reflect narrow understandings of HIV and AIDS as a predominantly medical problem, while depicting HIV/AIDS management as a top-down activity dominated by prominent individuals, such as national leaders, health professionals and philanthropists, thus marginalising the role played by communities, who are often depicted as passive recipients of interventions by active outsiders. These representations fail to reflect the key role played by members of grassroots communities in responding to the HIV epidemic. Such representations provide flawed conceptual tools for shaping responses to the epidemic, given that HIV-related programmes are unlikely to have optimal outcomes unless they resonate with the perceived needs and interests of their target communities, as we contend that effective HIV/AIDS management is best achieved through active participation by communities in HIV/AIDS management strategies. We discuss the implications of a more 'civic-minded journalism.'

  14. Probabilistic programmable quantum processors

    International Nuclear Information System (INIS)

    Buzek, V.; Ziman, M.; Hillery, M.

    2004-01-01

    We analyze how to improve performance of probabilistic programmable quantum processors. We show how the probability of success of the probabilistic processor can be enhanced by using the processor in loops. In addition, we show that an arbitrary SU(2) transformations of qubits can be encoded in program state of a universal programmable probabilistic quantum processor. The probability of success of this processor can be enhanced by a systematic correction of errors via conditional loops. Finally, we show that all our results can be generalized also for qudits. (Abstract Copyright [2004], Wiley Periodicals, Inc.)

  15. A programme in transition

    International Nuclear Information System (INIS)

    Dean, S.O.

    1992-01-01

    Fusion is beginning its transition from a scientific research programme to that of an engineering development programme aimed at practical applications. This transition is likely to last a decade or more because many scientific questions remain and because of the magnitude and cost of the engineering issues. This article reviews briefly the encouraging results produced at the Joint European Torus (JET) where 1.7 MW of fusion power was generated for 2 seconds in experiments in November 1991, the remaining scientific issues, the role of near-term experimental reactors like the International Thermonuclear Experimental reactor (ITER) and other approaches to a demonstration power plant. (author)

  16. Computer mathematics for programmers

    CERN Document Server

    Abney, Darrell H; Sibrel, Donald W

    1985-01-01

    Computer Mathematics for Programmers presents the Mathematics that is essential to the computer programmer.The book is comprised of 10 chapters. The first chapter introduces several computer number systems. Chapter 2 shows how to perform arithmetic operations using the number systems introduced in Chapter 1. The third chapter covers the way numbers are stored in computers, how the computer performs arithmetic on real numbers and integers, and how round-off errors are generated in computer programs. Chapter 4 details the use of algorithms and flowcharting as problem-solving tools for computer p

  17. The African interpretations of a set of values in a value-based HIV ...

    African Journals Online (AJOL)

    This article focuses on a qualitative exploration of six core values embedded in the Choose Life Training Programme (CLTP), a value-based HIV and AIDS prevention programme. The article is based on a study that explored the possibility that the African interpretations of these values are different to the Western definitions.

  18. A Locus of Control-based HIV and AIDS Risk Reduction Training ...

    African Journals Online (AJOL)

    The aim of this study was to investigate the effi cacy of a locus of control-based training programme in reducing HIV and AIDS risk among university students. The locus of control-based variables that formed the training programme were social systems control, deferment of gratifi cation, personal values and expectancies, ...

  19. The central role of national programme management for the achievement of malaria elimination: a cross case-study analysis of nine malaria programmes.

    Science.gov (United States)

    Smith Gueye, Cara; Newby, Gretchen; Tulloch, Jim; Slutsker, Laurence; Tanner, Marcel; Gosling, Roland D

    2016-09-22

    A malaria eradication goal has been proposed, at the same time as a new global strategy and implementation framework. Countries are considering the strategies and tools that will enable progress towards malaria goals. The eliminating malaria case-study series reports were reviewed to identify successful programme management components using a cross-case study analytic approach. Nine out of ten case-study reports were included in the analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for malaria elimination programme management was developed and data were extracted and synthesized. Findings were reviewed at a consultative workshop, which led to a revision of the framework and further data extraction and synthesis. Success factors of implementation, programme choices and changes, and enabling factors were distilled. Decentralized programmes enhanced engagement in malaria elimination by sub-national units and communities. Integration of the malaria programme into other health services was also common. Decentralization and integration were often challenging due to the skill and experience levels of newly tasked staff. Accountability for programme impact was not clarified for most programmes. Motivation of work force was a key factor in maintaining programme quality but there were few clear, detailed strategies provided. Different incentive schemes targeted various stakeholders. Training and supervision, although not well described, were prioritized by most programmes. Multi-sectoral collaboration helped some programmes share information, build strategies and interventions and achieve a higher quality of implementation. In most cases programme action was spurred by malaria outbreaks or a new elimination goal with strong leadership. Some programmes showed high capacity for flexibility through introduction of new strategies and tools. Several case-studies described methods for monitoring

  20. HIV continuum of care in Europe and Central Asia.

    Science.gov (United States)

    Drew, R S; Rice, B; Rüütel, K; Delpech, V; Attawell, K A; Hales, D K; Velasco, C; Amato-Gauci, A J; Pharris, A; Tavoschi, L; Noori, T

    2017-08-01

    The European Centre for Disease Prevention and Control (ECDC) supports countries to monitor progress in their response to the HIV epidemic. In line with these monitoring responsibilities, we assess how, and to what extent, the continuum of care is being measured across countries. The ECDC sent out questionnaires to 55 countries in Europe and Central Asia in 2014. Nominated country representatives were questioned on how they defined and measured six elements of the continuum. We present our results using three previously described frameworks [breakpoints; Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets; diagnosis and treatment quadrant]. Forty countries provided data for at least one element of the continuum. Countries reported most frequently on the number of people diagnosed with HIV infection (37; 93%), and on the number in receipt of antiretroviral therapy (ART) (35; 88%). There was little consensus across countries in their approach to defining linkage to, and retention in, care. The most common breakpoint (>19% reduction between two adjacent elements) related to the estimated number of people living with HIV who were diagnosed (18 of 23; 78%). We present continuum data from multiple countries that provide both a snapshot of care provision and a baseline against which changes over time in care provision across Europe and Central Asia may be measured. To better inform HIV testing and treatment programmes, standard data collection approaches and definitions across the HIV continuum of care are needed. If countries wish to ensure an unbroken HIV continuum of care, people living with HIV need to be diagnosed promptly, and ART needs to be offered to all those diagnosed. © 2017 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.