Lipidemia status among HIV positive adult male on HAART attending the HIV clinic at Kericho district hospital, Kericho

Background: It is unfortunate that while Highly Active Anti-retroviral Therapy (HAART) has become the standard of care among HIV positive patients, the medications have been associated with metabolic abnormalities recognised to cause lipidemia.Objective: To establish lipidemia status among HIV positive adult male patients attending HIV clinic at Kericho District Hospital.Design: A cross sectional analytical study.Setting: HIV clinic at Kericho District Hospital, Kenya.Subjects: HIV positive adult male patientsResults: The results indicated that the mean age was 43.52 ± 9.17 years and out of which 82.27% were married. Primary Education level attained 40.97% .The mean lipid profile level was LDL 2.5 ± 1.05mmol/l, cholesterol 4.49 mmol/L ± 1.28 mmol/l, HDL 1.47 ± 0.58 mmol/l and triglycerides 1.96 ± 1.32 mmol/l, against the expected level of LDL (1.1. - 2.4 mmol/L), HDL (0.9 - 1.68 mmol/L) triglyceride (0.41 - 2.61 mmol/L) and total cholesterol (2.55 - 5.7 mmol/L).The prevalence lipidemia was 48.17%.Conclusion: The findings showed that the mean LDL was elevated with proportion of lipidemia at a significant higher level among HIV positive adult patients on HAART with considerable improvement in the nutritional status. Future work should investigate the biological mechanisms and pathways through which micronutrients affects high density lipoprotein (HDL) and low density lipoproteins (LDL)

Nutritional status of adult male on art at Kericho District Hospital, Kericho County, Kenya

Background: Nutrition and HIV are strongly related and any immune impairment as a result of HIV leads to malnutrition while malnutrition leads to immune impairment and thus worsens the effect of HIV. Individuals living with HIV have special nutritional needs irrespective of whether they are on anti-retroviral treatment or receiving care services.Objective: To establish nutritional status of adult male on ART at Kericho District Hospital, Kenya.Design: Cross sectional analytical study.Setting: HIV clinic at Kericho District Hospital, Kenya.Subjects: HIV positive adult male patientsResults: Body Mass Index ≥18.5 and ≤ 24.5 (70.92), >16 & < 18.5 (11.94), >25.5 and < 30 (11.94), ≤ 16 (2.58) and ≥30.Conclusion: There is a high burden of malnutrition among PLHIV on ART (29.1%). Nutritional assessment, Counseling and support (NACS) should be the key intervention during the course of chronic HIV care and follow up

Comparison of ALE finite element method and adaptive smoothed finite element method for the numerical simulation of friction stir welding

In this paper, the material flow around the pin during friction stir welding (FSW) is simulated using a 2D plane\ud strain model. A pin rotates without translation in a disc with elasto-viscoplastic material properties and the outer boundary of\ud the disc is clamped. Two numerical methods are used to solve this problem and an analytical solution is derived. The analytical\ud model is complementary to validate the two numerical methods, i.e. the arbitrary Lagrangian-Eulerian (ALE) method and the\ud adaptive smoothed finite elements method (ASFEM)

Eiland op drift : de sociale organisatie van een kleine Caribische samenleving : St. Eustatius

The island of St. Eustatius is one of the least known and forgotten places within the Kingdom of the Netherlands. Yet the island does have an illustrious history and it played an important part in trade within the Caribbean area, particularly in the eighteenth century. St. Eustatius was an important intermediary in the smuggling trade - especially of weapons - between Europe and the English colonies of North ,America who were fighting for their independence. From the nineteenth century onwards, however, the social economy of the island has, for a variety of reasons, continuously gone downhill. The construction of the oil refineries on Curaçao and Aruba, which also created jobs for many inhabitants of St. Eustatius, was not able to bring this economic decline to a halt.At the present time the island has to contend with numerous social and economic problems. There are few sources of income: agriculture and fishing stagnate, there is no industry of any importance and the island's Public Works Service functions as a disguised form of relief employment. it must be feared that the execution of infrastructural works, in particular the restorations of buildings of historic interest, can only offer incidental relief for the unemployment problem. In any event it is no real financial-economic reorganisation, since the necessary funds are largely made available by the Netherlands on an ad hoc basis. It is possible that small scale tourism can offer more perspective in the future.There is little social cohesion within the Statian society. This does not mean that the different social levels live in conflict or enmity with each other, but rather that there are certain social forces present within the society which stand in the way of a co-operative spirit or feelings of solidarity. The absence of these feelings is not coupled to particular characteristics inherent to the separate strata, but appear in all levels of society. We are thinking here principally of the autochthonic population. In particular, the character of the local politics and the religious diversity within this society determine to a large extent this absence of social cohesion.In many respects the island finds itself in a very dependent position. This dependence is not only of a geographical, but also of a socio -economic and cultural nature. This study aims at describing this precarious position as fully as possible. Besides this it will attempt to subject the backgrounds and the more fundamental causes of the socio -economic problems to a more thorough analysis. In the light of this we have set ourselves the task of seeking clarification in the following problem areas.1. How has the society of St. Eustatius developed throughout its history from a socio -economic viewpoint?2. What are the determinants and the characteristics of the present socio -economic position of the island, and in particular, what determinative aspects may be distinguished as arising from the political and religious processes within this society?3. What external forces help to determine the present socio -economic position of the island?The formulation of these questions gives direction to our sociographical work and is not in the first instance intended to form the basis for pioneering theoretical work within the field of Caribbean sociology.From the very beginning we have always believed that our study should have a clear practical relevance.The coming independence of the Netherlands Antilles demands studies that can contribute to an improvement and a strengthening of the socio -economic situation of the member communities within the new independent state. This justification is clearly described in the introduction to this study. The necessary attention to the formulation of the problems and the methodsand instruments of investigation is also given there.For the sake of familiarisation a short description of the location is given in the introductory paragraphs. Numerous problems which are to be discussed in more detail later on are touched upon there.The book consists further of four parts: the history of the island is described in part I; the economy of St. Eustatius is discussed in part II; a description and analysis of the social organization of this society follows in part Ill and in part IV a final review is given in which we attempt to present an integrated analysis of the material introduced so far.The history of the island has been somewhat turbulent. In the first chapter we will describe the colonisation of the island and its development from an agricultural colony to an important transit harbour for slaves and other "items of trade". This period reached a climax in the seventies of the eighteenth century. The year 1781 marks a turning point in the history of the island. In that year it was overrun and dismantled by a British fleet under the command of admiral Rodney. This is certainly not the only nor the most important reason why the island drifted slowly but surely into poverty during the nineteenth century. These developments are comprehensively treated in the second chapter of part I, in which equal attention is paid to the social and economic developments in our own century. Since the Second World War, (financial) aid to St. Eustatius has developed slowly but surely. This aid, however, did not, unfortunately, make an end of the poor socio -economic climate on the island.As already stated, part II of the book discusses the economy of the island. Describing this economic situation is a sad occasion. Structurally the situation can only be called very poor. In the recent past numerous reports have been published and advices given but, in our view, they are insufficiently based on a thorough study of the underlying causes of the socio -economic impasse. We describe the incomes situation and the problems connected with forms of employment in this part. Further the primary sources of income are reviewed and here it is noticed that the island government plays an important rôle as employer. In anticipation of what is to be remarked in the final review in this book, we consider the possible economic perspectives for this island in respect of its present economic situation. After having recorded some theoretical comments on the concept "culture of poverty,' we come to the conclusion that it is undesirable and dangerous to maintain this concept as a possible explanation for the economic malaise. The following part of the study describes and analyses the social organisation of the society. We pay attention to the social stratification in the first chapter of this part. Comments are placed by the different social layers making up the society, amongst other things differentiating between the autochthonic and allochthonic populations. Following this there is a fairly detailed description of some community services in which schooling particularly is placed in the broader context of the educational problems of the Netherlands Antilles as a whole.We have already remarked that the absence of social cohesion results to a large extent from both the nature and content of the island politics and from the religious diversity. This circumstance is sufficient reason for us to examine both institutions thoroughly in separate chapters. The concept "political patronage" is treated fairly deeply and theoretically in the discussionof politics on St. Eustatius. This theoretical excursion does have an instrumental rather than a theory-forming character. A better understanding of the functioning of the (political) patronage system as such will clarify, in our opinion, the insight in the way in which politics are carried on within the society described. Besides this we pay special attention to the historical development of the political life on the island as well as the growth of the party system.A theoretical excursion is also appropriate in the analysis of religious life on St. Eustatius. This excursion is principally directed to the development of sectarian groupings, of which the Seventh-Day Adventists are a striking example. There are three religious groups on St. Eustatius, the Methodists, the Roman Catholics and the Seventh-Day Adventists. The Seventh-DayAdventists through their pronounced way of life and their implacable attitude towards dissenters heavily influence the island's social organization.The nature and the origin of religious organization are subjected to an extensive review, whilst the manner in which religion helps structure community life is investigated.A sociographically oriented study is not complete without paying attention to the pattern of primary relations. We do this in the last chapter of part III by treating in detail the characteristics of the primary groups such as the family and the peer group.Before analysing the relationships within Statian family life we briefly describe how this material is treated in the relevant Caribbean sociology and anthropology.This theoretical intermezzo is not intended ot add new concepts to the still increasing store of theoretical ideas. The notes serve in the first place to give the reader more background information regarding the wide diversity of thought concerning Caribbean family life. We attempt to make our review as concrete as possible by treating fairly deeply what one might call "the round of life". Every day life in all its aspects is reviewed, with separate attention being given to the life styles of the young, the adult and the aged.This is backed up by demographic statistical material, partly taken from the results of the mini-census conducted by us on the island. The living conditions of the population are also given the necessary attention.The study is closed with a number of final comments in which we attempt to make a connection between the different socio -economic developments and the related psychological effects.We arrive at this synthesis through an analysis from three different viewpoints. In the first place we pay some attention to a number of important historical developments of a material nature as well as the psychological effects that accompany them. Following this we attempt to show how those island in stitutions have helped induce particular material developments. Here again psychological aspects play a significant rôle. Finally the connection that exists between particular material developments and the position that the island occupies within wider socio -economic and constitutional areas is treated in more depth.We do not give an analysis of possible causal relations in a strict statistical sense in this last chapter. We also do not attempt to determine the importances of the different connections relative to each other. The method used in the investigation and the character of our data do not permit such a thoroughgoing analysis. In these final thoughts we do, however, confront the material developments and the psychological effects stemming from different sources with each other. This is done with the help of a simple relation matrix in which four meaningful relation possibilities are anchored;- The effect of the historical development on the institutional form of the society.- The effect of the historical development on the external relations of the society.- The effect of the institutional forms on the external relations and- the effect of the external relations m the institutional forms.In these final considerations we of necessity consider more deeply the dependent position of the island. This more detailed treatment is coupled to a theoretical and critical discussion of the so-called "dependency theories".From our final reviewing we may conclude that only an integrated approach to the socio -economic development of the island has any chance of succes. Such a strategy should offer the means which both in combination and simultaneously can serve to reduce and/or remove the material and psychological barriers resulting from the historical developments, the institutional forms and the external dependence respectively. Only then is there a chance that the willingness of the population for change can be increased, after which the realisation of this change can be carried through in a fruitful manner. It is evident that this has important consequences for the manner in which the aid to St. Eustatius should be given.In the last paragraph of this study we attempt to formulate a programme of starting points and lines of action which can serve as the "Leitbild" for an adequate development strategy for an island which, although unintentionally, has without a doubt gone adrift.<p/

Obstetrical Outcomes of Aboriginal Pregnancies at a Major Urban Hospital

While a number of previous papers have documented the poor general health of Australia's Aboriginal population, relatively few have considered the health of Aborigines living in Australia's urban centres. In this latter instance, Aborigines have access to conventional medical services and they live in a physical environment that does not differ greatly from that experienced by the lower-class white population. Of course, racial, familial and economic differences may continue to influence differentially the perceived accessibility of services to Aborigines and their non-Aboriginal neighbours. This paper compares the pregnancy outcomes of Aboriginal women and non-Aboriginal women living in a major urban centre in Australia. The data indicate that urban Aboriginal women have adverse pregnancy outcomes at one and a half o two times the rate experienced by the non-Aboriginal population. Much of the difference can be attributed to lifestyle variations in the groups being compared

Intrauterine Growth and Intelligence Within Sibling Pairs: Findings From the Mater-University Study of Pregnancy and its Outcomes

Objective: To examine the association between intrauterine growth and intelligence. Design: Population based birth cohort study of sibling pairs born within a maximum of three years of each other. Setting: Mater-University women and children's hospital, Brisbane, Australia. Participants: 235 (470 children) sibling pairs. Results: Among one randomly selected sibling from each pair verbal comprehension at age 5, general intelligence at age 14, and reading ability at age 14 increased linearly with increasing gestational age and sex standardised birth weight z scores. With adjustment for maternal age, race, and smoking during pregnancy, birth order, family income, and parental education the associations with verbal comprehension at age 5 and general intelligence at age 14 remained, whereas the association with reading ability at age 14 was attenuated to the null. Within sibling pairs, differences in intrauterine growth were positively associated with differences in verbal comprehension at age 5 (test score difference per one unit difference in birth weight z score = 1.52 (0.11 to 3.26)) and general intelligence at age 14 (1.09 (0.01 to 2.18)), but not with reading ability at age 14. Conclusions: Socioeconomic position or other fixed maternal characteristics do not seem to explain the positive association between intrauterine growth and childhood intelligence

Cohort Profile: The Mater-University of Queensland Study of Pregnancy (MUSP)

How did the study come about? At the initiative of three hospital-based obstetricians one of the authors (JMN) and another sociologist attended a 1978 meeting to explore the potential for collaborative research. No specific project was proposed by the obstetricians. Two of the obstetricians had been trained in Scotland; one in Aberdeen where he had had some familiarity with the work of obstetrician Dugald Baird and sociologist Raymond Illsely. The obstetricians argued for an agenda which was clinically oriented. The two sociologists were more focussed on understanding how some social constructs (e.g. social class) might be relevant to explaining health outcomes. The initial year of the study was characterised by frequent (at least weekly) meetings at which the aims and substance of the proposed study were debated vigorously. As an initial decision the team focused on factors associated with adverse pregnancy outcomes. The first major project was to be a 3-5 year longitudinal study of pregnant women which would include a 6-month child post-natal follow-up as the main outcome of interest

Postnatal Depression - Myth and Reality: Maternal Depression Before and After the Birth of a Child

Background Much has been written about postnatal depression as a clinical condition. There is some evidence to suggest that a substantial proportion of women who give birth experience a depression in the postnatal period. This paper reports the results of a longitudinal study of the mental health of a large sample of women who were in the early stages of pregnancy at entry to the study. Methods Each participant was assessed for symptoms of depression at the first clinic visit (entry to the study), and reassessed at various intervals - at 3-5 days, at 6 months, and again at 5 years after the birth of the child - using the DSSI-D (Delusions-Symptoms-States Inventory). Results Retrospective recall questions indicate that shortly after the birth the majority of women experienced some depressed mood. Of those who experienced depressed mood, the data suggest that the symptoms were not severe, nor did these symptoms generally continue beyond a few weeks. The longitudinal data indicate that levels of depression in our sample are highest either at the firrst clinic visit or at the 5-year follow-up. Rates of depression at the 6-month follow-up are relatively low by comparison. Conclusion While most mothers experience periods of depressed mood after the birth of their baby, these periods are generally of short duration and of lesser intensity than a major depression. Mothers appear to experience increasing levels of symptoms of depression as their child grows up. Many of the "cases" of depression experienced at the 5-year follow-up represent a recurrence of a previous experience of depression

Behavioural and Cognitive Associations of Short Stature at 5 Years

Objectives To determine the extent to which childhood short stature is associated with cognitive, behavioural and chronic health problems, and whether these problems could be attributed to recognized adverse biological, psychosocial or psychological factors. Methodology At their first antenatal session, 8556 women were enrolled in a prospective study of pregnancy. When their children were 4 and 6 years of age, mothers completed a detailed questionnaire concerning their child's health and behaviour. A Peabody Picture Vocabulary Test-Revised (PPVT-R) was completed by the child at 5 years of age. Z scores were used to categorize height measurements in 3986 children. The relationship of these height categories with the child's health, and behavioural and cognitive problems was then examined. Results No association was found between height and symptoms of chronic disease or behaviour problems in boys or girls. On the unadjusted analysis, mean PPVT-R scores were significantly lower in boys with heights < 3 percentile and 3-10 percentile compared with study children between 10 to 90 percentile (P < 0.01). Scores were similarly significantly lower in girls with heights < 3 percentile and 3-10 percentile (P = 0.01). Even after adjusting for psychosocial and biological confounders, short stature remained a significant predictor for lower PPVT-R scores in both boys and girls, although height only accounted for 1.1% of the variance in scores in boys and 0.5% of the variance in PPVT-R scores in girls. Psychosocial factors had a greater role than height in determining PPVT-R scores at 5 years of age. Conclusions These findings suggest a significant, though small, association between height and PPVT-R scores at 5 years of age, independent of psychosocial disadvantage and known biological risk factors