Access to care in people living with HIV

Includes bibliographical references.South Africa has the most people living with HIV (PLWH) in the world. With increased access to HIV Counselling and Testing (HCT) as well as expanded Antiretroviral Therapy (ART) treatment guidelines; there is a large and increasing number of people who need access to HIV care. Limited data and few studies have evaluated access to HIV care. A cross sectional survey with stratified random sampling was conductedfrom January – April 2011 to determine the proportion of PLWH in urban areas in thegreater Cape Town area who are accessing appropriate HIV care and factors associatedwith accessing care. The sampling frame for this study was the Zambia South Africa TBand AIDS Reduction (ZAMSTAR) Study. Self reported HIV positive adults were randomly selected. Self reported HIV negative adults or adults of unknown HIV status were also randomly selected in order to decrease possible stigmatisation. Consenting participants were interviewed and completed a questionnaire detailing their access to HIV testing and care. Participants who disclosed that they were HIV positive were included in the analysis. Access to appropriate HIV care was defined as one of three scenarios: 1. Receiving ART and having attended an ART clinic or collected ART medication within the last three months. 2. Undergoing ART work up and having attended an ART clinic within the last three months. 3. In PreART care having had a CD4 count in the last 6 months. 1257 participants were interviewed. 627(50%) reported being HIV positive, 487(39%) HIV negative and 143(11%) did not know or wish to disclose their status. Of the 627 HIV positive participants: 392 (63%) reported taking ART of whom 369 (94%) accessed appropriate HIV care. 25 (4 %) were being worked up for ART of whom 16 (64%) accessed appropriate HIV care. 210 (33%) were in PreART care, 81 (39%) having accessed appropriate HIV care. Females were 3.78 times more likely to be in appropriate care than males (p <0.001), and a person in the age category greater than 45 years was 4.63 times more likely to be in appropriate care than someone in the age category 15-24 (p= 0.002)

South African road transport requirements for sustainable growth

Includes bibliographical references.The assumption that ownership of private motor vehicles as a right is questioned. This thesis is based on the hypothesis that in fact in the case of South Africa this will have many detrimental effects if allowed to continue. It is argued that for sustainable growth, other more attractive options exist. Developments in more developed countries are examined in order to prove that similar conclusions have been reached. The problem investigated in this thesis is therefore the non-sustainability of the continued growth of the private car population in South African urban centres. A literature survey was conducted on what other countries did with their transport problems but the same problem as in South Africa has not been encountered anywhere else in the world. South Africa therefore has a unique situation, which needs to be resolved in a unique way. There is increasing awareness elsewhere in the world that the causes of most of the problems experienced in the transport sector are deficiencies in the efficient operation of markets. Environmental costs are neglected or underestimated in transport prices. As a result, the individual transport user receives distorted price signals. Failure to respect economic principles results in waste, characterised in the transport sector by high accident rates, health problems, negative environmental impacts, financial constraints in the public transport sector and an increase in congestion that persist because users perceive them only indirectly

Maternal Mental Health: A prospective longitudinal cohort study of the outcome of planned versus unplanned pregnancy in women with major psychiatric disorders in a developing country

Psychiatr

Investigating the influences of context on the information seeking behaviour of first-generation students

This paper reports on a qualitative study investigating the information seeking behaviour of first-generation students enrolled at the University of Johannesburg, South Africa, in the Humanities’ Mastering Academic and Professional Skills programme. The purpose is to determine the way in which their socio-economic situations influenced their ability to solve information problems. The target population come from low-income families with low social and cultural capacity in their home environment. A qualitative phenomenological research approach was followed. A purposive convenience sample was drawn from the target population. A total of 17 students participated in the study. Qualitative data analysis procedures were used with inductive reasoning as an open-ended approach. The data were collected using interviews with an open- and close-ended interview schedule. Both contextual (environmental) and personal experiences influence the information seeking behaviour of first-generation students. Information literacy as an intervention served as a catalyst to change the students’ information seeking behaviour. An understanding of first-generation students’ information seeking behaviour can provide insights for librarians on the way in which to meet these students’ information needs.Peer Reviewe

It takes a village : a survey of women\u27s experiences of emotional support during prenatal care visits

Research has shown that post-partum depression often begins during pregnancy. This study seeks to examine the extent to which prenatal care providers (PNCP\u27s) are sufficiently attending to the emotional concerns of their patients. This study consisted of 117 women. Participants were asked a series of rating questions to determine their overall satisfaction with their PNCP\u27s ability to attend to their emotional concerns. In addition to the rating questions, respondents were asked two open ended questions to better illustrate their experience with their PNCP, as well as to discuss which resources they felt would be helpful to women during pregnancy. While many of the women reported having a positive PNCP experience, discussion of emotional health during prenatal appointments were infrequent. The overall response to this survey was that having a greater focus on women\u27s emotional health would be beneficial to both mother and child. This study emphasizes the need for collaboration between social workers and PNCP\u27s as a way to provide more holistic and patient-centered care for pregnant women

Information seeking behaviour of first-generation students at the University of Johannesburg

This study is an investigation into the information seeking behaviour of first-year first generation (FG) students. The qualitative phenomenological approach was applied to sought understanding of factors influencing this groups’ information seeking behaviour. It endeavoured to determine the students’ information literacy abilities and benchmark these against the library’s current information literacy training course. A purposive convenience sample was drawn from FG students enrolled in the extended programme of the Mastering Academic and Professional Skills (MAPS) in the Humanities at the University of Johannesburg (UJ) who completed the library’s information literacy course. Seventeen students participated. A literature review indicated that FG students’ socioeconomic situations in their homes leave them academically unprepared for higher education, with inadequate cognitive skills to solve information problems and carry out academic tasks, which in an academic context require information literacy skills. The empirical findings confirmed this. The literature revealed interplay between the academic context and the study group’s everyday life context giving rise to the group’s information needs and triggering information seeking activities. Situations in the students’ everyday life context and academic context influenced their information seeking behaviour. Interconnectedness between contextual components and their personal experiences was evident in their information seeking behaviour, which reflected an inability to find information to support their information needs. The intervention of the library’s information literacy training course improved the respondents’ information literacy skills and enabled them to find the required information. The findings enabled the development of a conceptual model graphically illustrating FG students’ information seeking behaviour. Furthermore, the library’s information literacy training course could be reviewed and improved by exploring a more blended learning approach; making the online component of the course more user-friendly; training MAPS mentors in information literacy so that they can fully assist the FG students; educating librarians on FG students’ information seeking behaviour. This study yielded understanding of the influence of two different contexts influencing information seeking behaviour and facilitated employment of an adapted information literacy training course to equip FG students to function successfully in an academic context.Information ScienceD. Litt. et. Phil. (Information Science

The rate inhibiting effect of water as a product on reactions catalysed by cation exchange resins : formation of mesityl oxide from acetone as a case study

It is known that when water is a product in reactions catalysed by cation exchange resins, it inhibits the reaction rate much more than predicted by the reverse reaction or dilution effects. In this work the inhibiting effect is ascribed to the preferential association of the catalytically active sites with water. In the derivation of the kinetic model, a Freundlich type adsorption isotherm was used to quantify the number of sites occupied by water. This is combined with a power law expression for the reaction rate. The resultant expression can accurately predict the reaction rate for various initial concentrations of water and mesityl oxide. Even when water was initially added to the reaction mixture, this model still gave an absolute average error of 6.5% compared to a 54.6% error when the same approach was followed but with the more popular Langmuir isotherm to describe site deactivation. The kinetic expression previously proposed for this reaction system by Klein and Banchero also failed when water was added to the reaction mixture and gave an average error of 71.1%. The procedure used to derive the model is therefore suggested for all cation exchange catalysed reactions where water is one of the products.Dissertation (MSc)--University of Pretoria, 2005.Chemical Engineeringunrestricte

Effect of fines content on bubble properties in a two-dimensional fluidized bed by digital image analysis

The effect of fines content in fluid catalytic cracking (FCC) catalyst on bubble properties was investigated by considering two catalyst batches. One contained fewer fines and had a Sauter mean diameter of 83 μm while the other had a higher fines content with a 74 μm mean diameter. The hydrodynamics were analyzed in a two-dimensional fluidized bed with superficial gas velocities in the bubbling regime. Photos of the bed were analysed by isolating bubble images, after which colour images were converted to binary images by using MATLAB® software. These binary images were used to determine properties such as equivalent bubble diameter, gas fraction, circularity and bubble hold-up in the bed as function of superficial gas velocity and fines content. The results showed that bubble diameter increases with gas velocity for both catalyst batches. A smaller bubble size was observed at all except the highest superficial velocities for the catalyst batch with the higher fines content. However, the high fines content catalyst had a higher gas fraction than the low fines content batch at all gas velocities. This average value was the same regardless of gas velocity, while an increase in superficial velocity resulted in an increase in gas fraction for the lower fines content catalyst. The bubble hold-up for the catalyst batch with the lower fines content was also higher than that of the high fines content catalyst. For both batches an increase in bubble hold-up with velocity was observed. Similar circularity values for both catalyst types were calculated at all superficial velocities.http://www.saiche.co.za/article.aspam2013ai201

Axial variation of wetting efficiency and liquid-solid mass transfer in long trickle bed columns

The wetting efficiency and solid liquid mass transfer coefficient was measured separately and simultaneously using the electrochemical cell technique while varying the superficial liquid velocity and hydrodynamic state of the column by using different pre-wetting procedures. The wetting efficiency in columns with an aspect ratio - distance from distributor divided by column diameter – of up to 33, decreased with distance from the distributor regardless of the hydrodynamic state of the column. Although the solid liquid mass transfer coefficient also decreased with an increase in axial position, this decrease was much more significant where the pre-wetting procedure that resulted in a lower overall wetting efficiency was used. When a pre-wetting procedure that resulted in a higher average wetting efficiency was used, the liquid solid mass transfer coefficient was much less dependent on liquid velocity and only a relatively small decrease with axial position was observed. The results highlight the difference in surface renewal processes that is possible between columns operated at the same conditions but under different hydrodynamic states and emphasise the importance of hydrodynamic multiplicity when liquid redistribution is considered.http: pubs.acs.org/IECRhb201

Missed opportunities for retention in pre-ART care in Cape Town, South Africa

BACKGROUND: Few studies have evaluated access to and retention in pre-ART care. Objectives To evaluate the proportion of People Living With HIV (PLWH) in pre-ART and ART care and factors associated with retention in pre-ART and ART care from a community cohort. METHODS: A cross sectional survey was conducted from February - April 2011. Self reported HIV positive, negative or participants of unknown status completed a questionnaire on their HIV testing history, access to pre-ART and retention in pre-ART and ART care. RESULTS: 872 randomly selected adults who reported being HIV positive in the ZAMSTAR 2010 prevalence survey were included and revisited. 579 (66%) reconfirmed their positive status and were included in this analysis. 380 (66%) had initiated ART with 357 of these (94%) retained in ART care. 199 (34%) had never initiated ART of whom 186 (93%) accessed pre-ART care, and 86 (43%) were retained in pre-ART care. In a univariable analysis none of the factors analysed were significantly associated with retention in care in the pre-ART group. Due to the high retention in ART care, factors associated with retention in ART care, were not analysed further. CONCLUSION: Retention in ART care was high; however it was low in pre-ART care. The opportunity exists, if care is better integrated, to engage with clients in primary health care facilities to bring them back to, and retain them in, pre-ART care