Model of Empowerment to Improve Autonomy Directly Observed Treatment (DOT) Tuberculosis Patients

Empowerment as not yet optimal health promotion efforts done to enhance the autonomy of Directly Observed Treatment (DOT), which affect the success of the recovery of patients with pulmonary tuberculosis. The purpose of research was to develop a model empowerment based on Health Promotion and Health Literacy with approach to nursing intervention in an effort enhance the autonomy of the DOT - pulmonary TB patients. The method was an observational analytic with cross sectional approach. Multistage random sampling was DOT-pulmonary TB patients to decide the district and simple random sampling was assigned to choose the participants, a total of 253 DOT- pulmonary TB patients new case with acid resistant bacilli positive on the advanced phase in this study. The study conducted in five districts in Surabaya City (center, north, south, east and west). Data were collected by questionnaire on variables namely personal, cognitive and affective, nursing intervention, commitment, family supports, health literacy and DOT- autonomy. Structural Equation Modeling (SEM) with LISREL is used for constructing predictive model. Result : This study found a new model which was developed based on combination of Health Promotion Model (HPM) and Health Literacy (HL). Statistical result confirm that personal, cognitive and affective, health literacy and family support considered as important factors in improving DOT-autonomy. Conclusion : DOT- autonomy will improve by considering four main factors, personal, cognitive and affective, health literacy, family support. This model can be adapted by District Health Office Surabaya City as the main actor regional health development. In addition, this model may become a reference for other district in improving their nursing intervention in community setting

Geoadditive Latent Variable Modelling of Count Data on Multiple Sexual Partnering in Nigeria

The 2005 National HIV/AIDS and Reproductive Health Survey in Nigeria provides evidence that multiple sexual partnering increases the risk of contracting HIV and other sexually transmitted diseases. Therefore, partner reduction is one of the prevention strategies to accomplish the Millenium development goal of halting and reversing the spread of HIV/AIDS. In order to explore possible association between sexual partnering and some risk factors, this paper utilizes a novel Bayesian geoadditive latent variable model for count outcomes. This allows us to simultaneously analyze linear and nonlinear effects of covariates as well as spatial variations of one or more latent variables, such as attitude towards multiple partnering, which in turn directly influences the multivariate observable outcomes or indicators. Influence of demographic factors such as age, gender, locality, state of residence, educational attainment, etc., and knowledge about HIV/AIDS on attitude towards multiple partnering is also investigated. Results can provide insights to policy makers with the aim of reducing the spread of HIV and AIDS among the Nigerian populace through partner reduction

Ivermectin Treatment and Sanitation Effectively Reduce Strongyloides stercoralis Infection Risk in Rural Communities in Cambodia

BACKGROUND: Strongyloides stercoralis is the only soil-transmitted helminth with the ability to replicate within its host, leading to long-lasting and potentially fatal infections. It is ubiquitous and its worldwide prevalence has recently been estimated to be at least half that of hookworm. Information on the epidemiology of S. stercoralis remains scarce and modalities for its large-scale control are yet to be determined. METHODOLOGY/PRINCIPAL FINDINGS: A community-based two-year cohort study was conducted among the general population in a rural province in North Cambodia. At each survey, participants infected with S. stercoralis were treated with a single oral dose of ivermectin (200μg/kg BW). Diagnosis was performed using a combination of the Baermann method and Koga agar plate culture on two stool samples. The cohort included participants from eight villages who were either positive or negative for S. stercoralis at baseline. Mixed logistic regression models were employed to assess risk factors for S. stercoralis infection at baseline and re-infection at follow-up. A total of 3,096 participants were examined at baseline, revealing a S. stercoralis prevalence of 33.1%. Of these participants, 1,269 were followed-up over two years. Re-infection and infection rates among positive and negative participants at baseline were 14.4% and 9.6% at the first and 11.0% and 11.5% at the second follow-up, respectively. At follow-up, all age groups were at similar risk of acquiring an infection, while infection risk significantly decreased with increasing village sanitation coverage. CONCLUSIONS/SIGNIFICANCE: Chemotherapy-based control of S. stercoralis is feasible and highly beneficial, particularly in combination with improved sanitation. The impact of community-based ivermectin treatment on S. stercoralis was high, with over 85% of villagers remaining negative one year after treatment. The integration of S. stercoralis into existing STH control programs should be considered without further delay

Geoadditive latent variable modelling of count data on multiple sexual partnering in Nigeria

The 2005 National HIV/AIDS and Reproductive Health Survey in Nigeria provides evidence that multiple sexual partnering increases the risk of contracting HIV and other sexually transmitted diseases. Therefore, partner reduction is one of the prevention strategies to accomplish the Millenium development goal of halting and reversing the spread of HIV/AIDS. In order to explore possible association between sexual partnering and some risk factors, this paper utilizes a novel Bayesian geoadditive latent variable model for count outcomes. This allows us to simultaneously analyze linear and nonlinear effects of covariates as well as spatial variations of one or more latent variables, such as attitude towards multiple partnering, which in turn directly influences the multivariate observable outcomes or indicators. Influence of demographic factors such as age, gender, locality, state of residence, educational attainment, etc., and knowledge about HIV/AIDS on attitude towards multiple partnering is also investigated. Results can provide insights to policy makers with the aim of reducing the spread of HIV and AIDS among the Nigerian populace through partner reduction.factor loading; geographical variations; latent variable model; MCMC; Nigeria; semiparametric Poisson model

A semiparametric cure model for interval-censored data

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How good are rodent models of carcinogenesis in predicting efficacy in humans? A systematic review and meta-analysis of colon chemoprevention in rats, mice and men

Tumours in rodent and human colon share many histological and genetic features. To know if rodent models of colon carcinogenesis are good predictors of chemopreventive efficacy in humans, we made a meta-analysis of aspirin, beta-carotene, calcium, and wheat bran studies. Controlled intervention studies of adenoma recurrence in human volunteers were compared with chemoprevention studies of carcinogen-induced tumours in rats, and of polyps in Min (Apc(+/-)) mice: 6714 volunteers, 3911 rats and 458 mice were included in the meta-analyses. Difference between models was small since most global relative risks were between 0.76 and 1.00. A closer look showed that carcinogen-induced rat studies matched human trials for aspirin, calcium, carotene, and were compatible for wheat bran. Min mice results were compatible with human results for aspirin, but discordant for calcium and wheat bran (no carotene study). These few results suggest that rodent models roughly predict effect in humans, but the prediction is not accurate for all agents. Based on three cases only, the carcinogen-induced rat model seems better than the Min mouse model. However, rodent studies are useful to screen potential chemopreventive agents, and to study mechanisms of carcinogenesis and chemoprevention