Research Process Analysis of a Survey on Access to HIV/AIDS Care among Health Care Workers in Swaziland

In October 2007 the Swaziland Nursing Association (SNA), in collaboration with the South African Human Capacity Development Project (SA-HCD) and the Capacity Project - IntraHealth International, came together to conduct a survey on the „Access to HIV/AIDS care among health care workers in Swaziland.‟ The research stemmed from the observation of high rates of HIV/ AIDS fear and stigma among health workers, poor utilization of HIV care and support facilities by these health care workers, and health workers‟ concerns regarding breach of confidentiality. The objectives of the survey were largely two-fold: a. To assess health care workers‟ knowledge and access to work place HIV/AIDS infection prevention and control and to determine the barriers to receiving HIV/AIDS care and support by health care workers and their families. b. To use the knowledge obtained from the survey in a targeted intervention to reduce potential barriers to HIV/AIDS care among health care workers. The aim of this paper, written before the data analysis, is to present a descriptive analysis of the research process, critically analyze the research methods, and discuss possible strengths and limitations of the methods and the implications for further research. Analysis of the methods showed that like all research processes, the HCW survey is not without its strengths and biases. Methodological challenges such as contextual documentation, sampling, and time and human resource constraints were all factors that played into the research process and are important factors to be considered in the data analysis and results interpretations. The importance of community participatory approaches and training were found to have been great initiatives in the research process by way of the commitment, depth and ownership it imparted to the study. Additionally, the relevance of knowledge and awareness of the research context was highlighted in the quality imparted to the data collection processes. Based on this research process analysis, the need for the involvement of the survey implementers (nurses) in the data analysis and results interpretation is greatly emphasized in their ability to enhance the validity and reliability of the studies findings. In conclusion, capturing all aspects of the qualitative research process is imperative in ensuring in-depth understanding of the research data. It is hoped that information obtained from this research analysis will not only inform the data analysis and results write up of the health care workers‟ survey but also serve as a resource tool for future practice. The longer term goal of which would be that, subsequent interventions can build upon the information, to contribute to the establishment of a much needed resource data base for best practices in qualitative research development in the Kingdom of Swaziland.Master of Public Healt

Engaging Religious Institutions to Address Racial Disparities in HIV/AIDS: A Case of Academic-Community Partnership

African Americans face the most severe burden of HIV among all racial and ethnic groups. Direct involvement of faith leaders and faith communities is increasingly suggested as a primary strategy to reduce HIV-related disparities, and Black churches are uniquely positioned to address HIV stigma, prevention, and care in African American communities. The authors describe an academic-community partnership to engage Black churches to address HIV in a predominantly African American, urban, southern Midwest location.  The opportunities, process, and challenges in forming this academic-community partnership with Black churches can be used to guide future efforts toward engaging faith institutions, academia, and other community partners in the fight against HIV.

Water, sanitation, and hygiene interventions to improve health among people living with HIV/AIDS: a systematic review.

DESIGN: People living with HIV/AIDS (PLHIV) are at increased risk of diarrhoeal disease and enteric infection. This review assesses the effectiveness of water, sanitation, and hygiene (WASH) interventions to prevent disease among PLHIV. METHODS: We searched MEDLINE, EMBASE, Global Health, The Cochrane Library, Web of Science, LILACS, Africa-wide, IMEMR, IMSEAR, WPRIM, CNKI, and WanFang. We also hand searched conference proceedings, contacted researchers and organizations, and checked references from identified studies. Eligible studies were those involving WASH interventions among PLHIV that reported on health outcomes and employed a controlled study design. We extracted data, explored heterogeneity, sub-grouped based on outcomes, calculated pooled effects on diarrhoeal disease using meta-analysis, and assessed studies for methodological quality. RESULTS: Ten studies met the eligibility criteria and are included in the review, of which nine involved water quality interventions and one involved promotion of handwashing. Among eight studies that reported on diarrhoea, water quality interventions (seven studies, pooled RR = 0.57, 95% CI: 0.38-0.86) and the handwashing intervention (one study, RR = 0.42, 95% CI: 0.33-0.54) were protective against diarrhoea. One study reported that household water treatment combined with insecticide treated bednets slowed the progression of HIV/AIDS. The validity of most studies is potentially compromised by methodological shortcomings. CONCLUSION: No studies assessed the impact of improved water supply or sanitation, the most fundamental of WASH interventions. Despite some evidence that water quality interventions and handwashing are protective against diarrhoea, substantial heterogeneity and the potential for bias raise questions about the actual level of protection

Silver polyvinyl pyrrolidone nanoparticles exhibit a capsular polysaccharide influenced bactericidal effect against Streptococcus pneumoniae

Streptococcus pneumoniae remains a leading cause of morbidity and mortality worldwide. The highly adaptive nature of S. pneumoniae exemplifies the need for next generation antimicrobials designed to avoid high level resistance. Metal based nanomaterials fit this criterion. Our study examined the antimicrobial activity of gold nanospheres (AuNP), silver coated polyvinyl pyrrolidone (AgPVP), and titanium dioxide (TiO2) against various serotypes of S. pneumoniae. Twenty nanometer spherical AgPVP demonstrated the highest level of killing among the tested materials. AgPVP (0.6 mg/mL) was able to kill pneumococcal serotypes 2, 3, 4, and 19F within 4 hours of exposure. Detailed analysis of cultures during exposure to AgPVP showed that both the metal ions and the solid nanoparticles participate in the killing of the pneumococcus. The bactericidal effect of AgPVP was lessened in the absence of the pneumococcal capsular polysaccharide. Capsule negative strains, JD908 and RX1, were only susceptible to AgPVP at concentrations at least 33% higher than their respective capsule expressing counterparts. These findings suggest that mechanisms of killing used by nanomaterials are not serotype dependent and that the capsular polysaccharide participates in the inhibition. In the near future these mechanisms will be examined as targets for novel antimicrobials

Choroidal Thickness Profiles in Myopic Eyes of Young Adults in the Correction of Myopia Evaluation Trial Cohort

PurposeTo examine the relationship of choroidal thickness with axial length (AL) and myopia in young adult eyes in the ethnically diverse Correction of Myopia Evaluation Trial (COMET) cohort.DesignCross-sectional, multicenter study.MethodsIn addition to measures of myopia by cycloplegic autorefraction and AL by A-scan ultrasonography, participants underwent optical coherence tomography imaging of the choroid in both eyes at their last visit (14 years after baseline). Using digital calipers, 2 independent readers measured choroidal thickness in the right eye (left eye if poor quality; n = 37) at 7 locations: fovea and 750, 1500, and 2250 μm nasal (N) and temporal (T) to the fovea.ResultsChoroidal thickness measurements were available from 294 of 346 (85%) imaged participants (mean age: 24.3 ± 1.4 years; 44.9% male) with mean myopia of -5.3 ± 2.0 diopters and mean AL of 25.5 ± 1.0 mm. Overall, choroidal thickness varied by location (P < .0001) and was thickest at the fovea (273.8 ± 70.9 μm) and thinnest nasally (N2250, 191.5 ± 69.3 μm). Multivariable analyses showed significantly thinner choroids in eyes with more myopia and longer AL at all locations except T2250 (P ≤ .001) and presence of peripapillary crescent at all locations except T1500 and T2250 (P ≤ .0001). Choroidal thickness varied by ethnicity at N2250 (P < .0001), with Asians having the thinnest and African Americans the thickest choroids.ConclusionChoroids are thinner in longer, more myopic young adult eyes. The thinning was most prominent nasally and in eyes with a crescent. In the furthest nasal location, ethnicity was associated with choroidal thickness. The findings suggest that choroidal thickness should be evaluated, especially in the nasal regions where myopic degenerations are most commonly seen clinically