Technologies of treatment: Scaling up ART in the Western Cape, South Africa

This chapter examines technologies of 'treatment scaleup,' the extension of antiretroviral treatment (ART) to most or all of HIV positive people who need it, in the Western Cape, South Africa. The chapter describes three technologies related to ART scaleup: those of administration; partnership, rather different to the 'partnership' Campbell (this volume) describes and thirdly what we refer to as treatment citizenship. These non-medical treatment technologies operate alongside conventional medical treatment technologies to make up a successful, even exemplary ART scaleup. The chapter also argues that the success of these technologies derives from their involvement in a larger phenomenon: a new construction of 'HIV citizenship' within the Western Cape

Seismic evaluation and strengthening of reinforced concrete buildings

One of the best ways of achieving sustainability is to prolong the life span of existing structures instead of the “demolish and rebuild” option. Structure rehabilitation reduces construction waste, conserves natural resources, reduces negative environmental consequences, saves time, and saves cost, etc. Two main categories can be noticed in rehabilitation: repairing and strengthening. This study will focus on the strengthening category. The seismic analysis of existing reinforced concrete buildings before and after strengthening their columns is considered in this study. Three strengthening techniques (Ferro-cement jacket, steel jacket and Carbon fiber reinforced polymer jacket) are used to strengthen the reinforced concrete columns. The building is considered to be subjected to El Centro earthquake in two horizontal directions. The main objective is to investigate the optimum number and locations of the columns required to be strengthened so that the strengthened building satisfies the performance level. Four states of the building are considered; the original building and three strengthened buildings. The strengthening of a part of column height (only one meter along the potential plastic hinge) is considered. The results show that all three strengthening techniques are efficient to resist the seismic loads. This study helps engineers to select suitable, feasible and efficient strengthening techniques for structural members in existing buildings

COVID-19 IMPACT ON E-COMMERCE USAGE: AN EMPIRICAL EVIDENCE FROM MALAYSIAN HEALTHCARE INDUSTRY

Purpose of the study: The purpose of the study is to investigate the COVID-19 impact on e-commerce usage in the Malaysian healthcare industry through the Technological, Organizational, and Environmental (TOE) model. Methodology: This is a quantitative online survey-based research. The questionnaires are distributed among 100 samples from a healthcare provider, namely doctors, hospital management, medical assistant nurses, and medical supplier, particularly in Peninsular Malaysia. The sample comprised 45% male and 55% female. The data were analyzed by using SPSS 25 and PLS-SEM 3.0 to examine the relationship between variables and to test the hypotheses. Main Findings: The finding reveals that organization readiness, e-commerce knowledge, and supply chain integration have a significant positive impact. In contrast, IT infrastructure and external pressure have an insignificant effect on e-commerce usage. Applications of the Study: The benefits obtained from this study can be used to empower e-commerce usage in the healthcare industry of Malaysia. Also, it will enhance the quality of services hence advancing the healthcare services and operations. Novelty/Originality of the Study: The combined effect of the TOE and DOI theory on e-commerce usage for the healthcare industry to contribute to the literature

Effectiveness of the first district-wide programme for the prevention of mother-to-child transmission of HIV in South Africa

Objective: The aim of this study was to estimate the field efficacy of the first routine programme for the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) initiated in South Africa, in the subdistrict of Khayelitsha. Methods: A consecutive sample of 658 mother–infant pairs, identified from the PMTCT register from 1 March to 30 November 2003, were identified for enrolment in this study. Details of the regimen received were established and HIV status of the infants at between 6 and 10 weeks of age was determined by qualitative DNA polymerase chain reaction. Zidovudine (AZT) was provided antenatally from week 34 of gestation and during labour. Infant formula milk was offered to mothers who chose not to breastfeed. The protocol was amended in July 2003 such that women who had received 25 years was the only significant independent risk factor for transmission (odds ratio, 2.12; 95% CI, 1.14–4.07). Conclusion: The results of this study demonstrate the feasibility and effectiveness of a large-scale PMTCT programme in an urban public-sector setting

3MeV-electron beam induced threshold voltage shifts and drain current degradation on ZVN3320FTA & ZVP3310FTA commercial MOSFETs

Spacecraft, military mission requires electronic devices that are radiation hardened to extend exposure to ionizing radiation. Among many other semiconductors MOSFET is highly targeted due to its switching and amplifying application in electronics devices. This study investigates threshold voltage shifts and drain current degradation mechanism for both P-channel and N-channel commercial Si MOSFET subjected to low doses of electron beam radiation. It is observed that at lower dose of electron beam radiation, the mechanism responsible for threshold voltage shifts is generation-recombination of electron - hole pair. For the N-channel device positive threshold voltage shifts were observed and negative threshold voltage shifts were found in the P - channel device. Electron radiation induced defect states act as traps for drain current degradation. Experiment data to the above mention samples revealed that generation of electron-hole pair and built of traps centers creates the defects such as threshold voltage shifts and drain current degradation. These defects are obtained due to the penetration of 3MeV energy of electron beam dose level from 50KGy to 250KGy. The irradiated devices were evaluated through its shifts in the current and voltage characteristics, results were analyzed and plotted for the both N-channel and P-channel MOSFE

Unanticipated hospital admission after ambulatory surgery

The unplanned admission rate is considered to be an important measure of the quality of ambulatory surgical units. The objective of our study was to evaluate the unanticipated hospital admission rate from the Surgical Day Care (SDC) unit of our university affiliated teaching hospital and to analyze the reasons for admission. A review of all unanticipated admissions over a one-year period was done. The admission rate was calculated and the reasons for admission were analysed. The overall admission rate was 4.93%. Most of the admissions were ordered by the surgeons (97%). The main reasons for admission were patient observation indicated for various reasons (72%) and patient request (18%). Eighty percent of the admitted patients had received general anaesthesia. Admissions were also related to the male gender (69%), age over 65 years (27%) and surgeries ending in the afternoon (69%). On analyzing the reasons for admission, a large number of admissions were found to be due to preventable causes. We conclude that proper selection of patients, careful scheduling of lists and education of patients and clinical professionals can help to avoid many unanticipated admissions after day care surgical procedures

Antiretroviral therapy in a community clinic - early lessons from a pilot project

Objectives. To report on operational and clinical problems encountered during the first 6 months of a community-based antiretroviral therapy (ART) programme. Methods. ART was implemented in a primary care setting utilising an easily replicable service-delivery model based on a medical officer and nurse. Therapeutic counsellors, themselves HIV-infected, provided counselling and adherence support. Drug and monitoring costs were charitably funded and provincial health authorities supplied the medical infrastructure. The HIV Research Unit, University of Cape Town, supplied training and additional clinical support. Local HIV primary care clinics provided patient referrals. Standardised ART regimens were used with strict entry criteria (AIDS or CD4 count < 200 cells/µl). Results. Demand for the service was high. Referred patients had advanced disease (AIDS 57%, median CD4 count 96/µl) and high pre-treatment mortality (83/100 person-years). Mycobacterial disease was a major contributor to this mortality (40%). Scheduled clinic visit hours were six times higher during recruitment than maintenance. Attributable costs were: drugs 61%, staff 27%, viral load and CD4 cell counts 10% and safety monitoring 2%. Viral load after 16 weeks of therapy was < 400 copies/ml in the first 16 patients. Conclusions. ART can be successfully implemented within a primary care setting. Drug purchases and staff salaries drive programme costing. The service model is capable of managing 250 - 300 patients on chronic ART, but staffing needs to be increased during recruitment. Attention must be given to the diagnosis of tuberculosis during screening and early ART. Incorporating therapeutic counsellors into the programme increased community involvement and utilised a valuable and previously untapped resource

DETERMINATION OF DIVERSE ENVIRONMENTAL POLLUTION LEVEL FROM SELECTED AREAS OF RAWALPINDI, PAKISTAN

Anthropogenic contaminants arising from both stationary (power plants, industries and residential heating) and mobile sources (road traffic) can harm ambient air quality in urban areas. Depending upon their physical state, these pollutants are classified as liquid and vapor phases and are subsequently transported to the Earth’s surface through dry and wet deposition. After the deposition of these pollutants onto the surface of earth various health effects caused by these pollutants occurred like cardiovascular diseases and hypertension. In this study four different locations/sites were selected from the Rawalpindi city depending upon the population, traffic rush and industries to examine the noise level, concentration of carbon dioxide and heavy metals. Air sampler was used for the collection of air sample to analyze the heavy metal concentration, Quest electronic sound meter for measuring sound level and SIBATA for CO2 measurement. The study findings revealed that noise level was higher at all selected locations as described by WHO limit (70 dB) being highest at Industrial area due to heavy machinery and lowest at green area. Concentration of all four heavy metals were high as compared with the prescribed limits. CO2 level reaches up to 300 ppm because of coal consumption during the winter season. The threshold values of all these selected parameters well above the prescribed limits defined by the authorities so to combat with this situation we should move towards more energy efficient fuels, proper maintenance of vehicles and machineries, traffic management and installation of noise barriers in industries as well as installation of catalytic convertors in vehicles to stop further air pollution

Saponification of Diethyl Adipate with Sodium Hydroxide Using Reactive Distillation

This research presents a new study in reactive distillation by adopting a consecutive reaction . The adopted consecutive reaction was the saponification reaction of diethyl adipate with NaOH solution. The saponification reaction occurs in two steps. The distillation process had the role of withdrawing the intermediate product i.e. monoethyl adipate from the reacting mixture before the second conversion to disodium adipate occurred. It was found that monoethyl adipate appeared successfully in the distillate liquid. The percentage conversion from di-ester to monoester was greatly enhanced (reaching 86%) relative to only 15.3% for the case of reaction without distillation .This means 5 times enhancement . The presence of two layers in both the distillate and residual liquids was noticed ,the upper (water) layer and the lower (ester) layer. However, water layer was dominant in the distillate .The percentage excess of NaOH solution was calculated with respect to the concentration of monoester (9%-79%) and it was found that increasing the concentration of NaOH solution( until 40%) led to increase in the percentage conversion to monoester. It also led to get a pure monoester in the distillate and made the residual liquid appear as one layer. Maximum conversion had been occurred in the rang (40%-60%). After 60% the percentage conversion lowered noticeably

Emergence of a peak in early infant mortality due to HIV/AIDS in South Africa

Objectives: South Africa has among the highest levels of HIV prevalence in the world. Our objectives are to describe the distribution of South African infant and child mortality by age at fine resolution, to identify any trends over recent time and to examine these trends for HIV-associated and non HIV-associated causes of mortality. Methods: A retrospective review of vital registration data was conducted. All registered postneonatal deaths under 1 year of age in South Africa for the period 1997–2002 were analysed by age in months using a generalized linear model with a log link and Poisson family. Results: Postneonatal mortality increased each year over the period 1997–2002. A peak in HIV-related deaths was observed, centred at 2–3 months of age, rising monotonically over time. Conclusion: We interpret the peak in mortality at 2–3 months as an indicator for paediatric AIDS in a South African population with high HIV prevalence and where other causes of death are not sufficiently high to mask HIV effects. Intrauterine and intrapartum infection may contribute to this peak. It is potentially a useful surveillance tool, not requiring an exact cause of death. The findings also illustrate the need for early treatment of mother and child in settings with very high HIV prevalence