32 research outputs found
A study of patient attitudes towards decentralisation of HIV care in an urban clinic in South Africa
<p>Abstract</p> <p>Background</p> <p>In South Africa, limited human resources are a major constraint to achieving universal antiretroviral therapy (ART) coverage. Many of the public-sector HIV clinics operating within tertiary facilities, that were the first to provide ART in the country, have reached maximum patient capacity. Decentralization or "down-referral" (wherein ART patients deemed stable on therapy are referred to their closest Primary Health Clinics (PHCs) for treatment follow-up) is being used as a possible alternative of ART delivery care. This cross-sectional qualitative study investigates attitudes towards down-referral of ART delivery care among patients currently receiving care in a centralized tertiary HIV clinic.</p> <p>Methods</p> <p>Ten focus group discussions (FGDs) with 76 participants were conducted in early 2008 amongst ART patients initiated and receiving care for more than 3 months in the tertiary HIV clinic study site. Eligible individuals were invited to participate in FGDs involving 6-9 participants, and lasting approximately 1-2 hours. A trained moderator used a discussion topic guide to investigate the main issues of interest including: advantages and disadvantages of down-referral, potential motivating factors and challenges of down-referral, assistance needs from the transferring clinic as well as from PHCs.</p> <p>Results</p> <p>Advantages include closeness to patients' homes, transport and time savings. However, patients favour a centralized service for the following reasons: less stigma, patients established relationship with the centralized clinic, and availability of ancillary services. Most FGDs felt that for down-referral to occur there needed to be training of nurses in patient-provider communication.</p> <p>Conclusion</p> <p>Despite acknowledging the down-referral advantages of close proximity and lower transport costs, many participants expressed concerns about lack of trained HIV clinical staff, negative patient interactions with nurses, limited confidentiality and stigma. There was consensus that training of nurses and improved health systems at the local clinics were needed if successful down-referral was to take place.</p
Effect of nitrogen dioxide and other combustion products on asthmatic subjects in a home-like environment
Nitrogen dioxide (NO2) is one of a number of nitrogen compounds that are by-products of combustion and occur in domestic environments following the use of gas or other fuels for heating and cooking. In this study, we examined the effect of two levels of NO2 on symptoms, lung function and airway hyperresponsiveness (AHR) in asthmatic adults and children. In addition, in the same subjects, we examined the effects of the same levels of NO2 mixed with combustion by-products from a gas space heater.The subjects were nine adults, aged 19-65 yrs, and 11 children, aged 7-15 yrs, with diagnosed asthma which was severe enough to require daily medication. All subjects had demonstrable AHR to histamine. Exposures were for 1 h on five separate occasions, 1 week apart, to: 1) ambient air, drawn from outside the building; 2) 0.3 parts per million (ppm) NO2 in ambient air; 3) 0.6 ppm NO2 in ambient air; 4) ambient air + combustion by-products + NO2 to give a total of 0.3 ppm; and 5) ambient air + combustion by-products + NO2 to give a total of 0.6 ppm, Effects were measured as changes in lung function and symptoms during and 1 h after exposure, in AHR 1 h and 1 week after exposure, and in lung function and symptoms during the week following exposure.Exposure to NO2 either in ambient air or mixed with combustion by-products from a gas heater, had no significant effect on symptoms or lung function in adults or in children. There was a small, but statistically significant, increase in AHR after exposure to 0.6 ppm NO2 in ambient air. However, there was no effect of 0.6 ppm NO2 on AHR when the combustion by-products were included in the test atmosphere nor of 0.3 ppm NO2 under either exposure condition.We conclude that a 1 h exposure to 0.3 or 0.6 ppm NO2 has no clinically important effect on the airways of asthmatic adults or children, but that 0.6 ppm may cause a slight increase in airway hyperresponsiveness
Photoluminescence and electrical study of fluctuating potentials in Cu2ZnSnS4-based thin films
status: publishe
Effects of sulphurization time on Cu2ZnSnS4 absorbers and thin films solar cells obtained from metallic precursors
status: publishe
The influence of hydrogen in the incorporation of Zn during the growth of Cu2ZnSnS4 thin films
status: publishe
The Impact of Skin Grafting on the Quality of Life and Self-Esteem of Patients with Venous Leg Ulcers
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Molecular gas along a bright H filament in 2A 0335+096 revealed by ALMA
We present ALMA CO(1–0) and CO(3–2) observations of the brightest cluster galaxy (BCG) in the 2A 0335+096 galaxy cluster ( = 0.0346). The total molecular gas mass of 1.13 ± 0.15 × 10 is divided into two components: a nuclear region and a 7 kpc long dusty filament. The central molecular gas component accounts for 3.2 ± 0.4 × 10 of the total supply of cold gas. Instead of forming a rotationally supported ring or disk, it is composed of two distinct, blueshifted clumps south of the nucleus and a series of low-significance redshifted clumps extending toward a nearby companion galaxy. The velocity of the redshifted clouds increases with radius to a value consistent with the companion galaxy, suggesting that an interaction between these galaxies <20 Myr ago disrupted a pre-existing molecular gas reservoir within the BCG. Most of the molecular gas, 7.8 ± 0.9 × 10 , is located in the filament. The CO emission is co-spatial with a 10 K emission-line nebula and soft X-rays from 0.5 keV gas, indicating that the molecular gas has cooled out of the intracluster medium over a period of 25–100 Myr. The filament trails an X-ray cavity, suggesting that the gas has cooled from low-entropy gas that has been lifted out of the cluster core and become thermally unstable. We are unable to distinguish between inflow and outflow along the filament with the present data. Cloud velocities along the filament are consistent with gravitational free-fall near the plane of the sky, although their increasing blueshifts with radius are consistent with outflow.Support for this work was provided in part by the National Aeronautics and Space Administration through Chandra Award Number G05-16134X issued by the Smithsonian Astrophysical Observatory for an on behalf of the National Aeronautics and Space Administration under contract NAS8- 03060. A.N.V. and B.R.M. acknowledge support from the Natural Sciences and Engineering Research Council of Canada. B.R.M. further acknowledges support from the Canadian Space Agency Space Science Enhancement Program