Determinants of delay in the diagnosis and treatment of suspected tuberculosis by HIV status in South Africa

A research report submitted to the School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Masters in Science in Epidemiology and Biostatistics June 2017Introduction Delays in diagnosing and treating tuberculosis increase the risk of transmission, morbidity and mortality especially in low socio-economic settings with high HIV and TB rates. The aim of this study was to determine factors associated with the delay in the diagnosis and treatment of suspected TB by HIV status in hospitalised patients in South Africa. Methods This study was a secondary analysis of data from a three centre prospective cohort of inpatients recruited between 2006 and 2009 that were clinically diagnosed with active TB on admission. Results Data from 1018 patients (67% female) of a median age of 36 years (IQR: 30-44) with known HIV status were analysed: 875 (86%) positive and 143 (14%) negative. HIV positive patients had significantly longer median total delays relative to the negative (39 days, IQR: 28-74 vs. 32 days, IQR: 21-56; p<0.02). Unemployment, seeking prior treatment and use of cotrimoxazole predicted total delay in the HIV positive patients. Conclusion Patient delay is high in HIV positive patients compared to the HIV negative. Public health interventions targeting earlier diagnosis of TB disease in HIV positive patients should be enhanced.MT201

Guiding and including vulnerable-driven populations : Process of Vocational Guidance in the Transgender Popular Mocha Cellis High School

The work presents a vocational guidance proposal that was carried out in the Transgender Popular “Mocha Cellis”, High School in 2014. The intention is to promote reflection on the transgender population in terms of social and educational inclusion, and contribute to give visibility to the difficulties they experience. The proposal invites counselors to reflect on their own choices; such as the way to think about transgender population; and to assume the design of ethical guiding approaches.Facultad de Psicologí

Guiding and including vulnerable-driven populations : Process of Vocational Guidance in the Transgender Popular Mocha Cellis High School

The work presents a vocational guidance proposal that was carried out in the Transgender Popular “Mocha Cellis”, High School in 2014. The intention is to promote reflection on the transgender population in terms of social and educational inclusion, and contribute to give visibility to the difficulties they experience. The proposal invites counselors to reflect on their own choices; such as the way to think about transgender population; and to assume the design of ethical guiding approaches.Facultad de Psicologí

What characterizes Vacationers’ eWOM sharing behaviours? Unbundling Entertainment and Information Motives in Brand-related Social Media Sites

eWOM has increasingly become one of the sources of information relied on by vacationers to decide on where to go and where to stay. This article examines the influence of motivation on electronic word of mouth (eWOM) behaviour among vacationers in Tanzania. Four motivation variables from motivational psychology literature (information, altruism, social integration and entertainment) and the Uses and Gratification Theory are examined along three eWOM dimensions, namely giving, seeking and passing. Data for this study were collected using a structured questionnaire at three airports in Tanzania from 278 vacationers who had used social media for their trip. The data were analysed using structural equation modelling. The overall results indicate that vacationers’ eWOM behaviours are positively related to entertainment motivation. Alongside entertainment, eWOM giving and seeking behaviours are positively related to information and social integration, respectively while eWOM passing is positively related to altruistic motivation. Thus, the study concludes that entertainment motivation is the main driver of social media eWOM behaviours, hence a deviation from the past research that associated people’s participation in eWOM with information motives

Axonal outgrowth is associated with increased ERK 1/2 activation but decreased caspase 3 linked cell death in Schwann cells after immediate nerve repair in rats

<p>Abstract</p> <p>Background</p> <p>Extracellular-signal regulated kinase (ERK1/2) is activated by nerve damage and its activation precedes survival and proliferation of Schwann cells. In contrast, activation of caspase 3, a cysteine protease, is considered as a marker for apoptosis in Schwann cells. In the present study, axonal outgrowth, activation of ERK1/2 by phosphorylation (p-ERK 1/2 ) and immunoreactivity of cleaved caspase 3 were examined after immediate, delayed, or no repair of transected rat sciatic nerves.</p> <p>Results</p> <p>Axonal outgrowth, detected by neurofilament staining, was longer after immediate repair than after either the delayed or no repair conditions. Immediate repair also showed a higher expression of p-ERK 1/2 and a lower number of cleaved caspase 3 stained Schwann cells than after delayed nerve repair. If the transected nerve was not repaired a lower level of p-ERK 1/2 was found than in either the immediate or delayed repair conditions. Axonal outgrowth correlated to p-ERK 1/2, but not clearly with cleaved caspase 3. Contact with regenerating axons affected Schwann cells with respect to p-ERK 1/2 and cleaved caspase 3 after immediate nerve repair only.</p> <p>Conclusion</p> <p>The decreased regenerative capacity that has historically been observed after delayed nerve repair may be related to impaired activation of Schwann cells and increased Schwann cell death. Outgrowing axons influence ERK 1/2 activation and apoptosis of Schwann cells.</p

End-to-side nerve repair in the upper extremity of rat.

The end-to-side nerve-repair technique, i.e., when the distal end of an injured nerve is attached end-to-side to an intact nerve trunk in an attempt to attract nerve fibers by collateral sprouting, has been used clinically. The technique has, however, been questioned. The aim of the present study was to investigate end-to-side repair in the upper extremity of rats with emphasis on functional recovery, source, type, and extent of regenerating fibers. End-to-side repair was used in the upper limb, and the radial or both median/ulnar nerves were attached end-to-side to the musculocutaneous nerve. Pawprints and tetanic muscle force were used to evaluate functional recovery during a 6-month recovery period, and double retrograde labeling was used to detect the source of the regenerated nerve fibers. The pawprints showed that, in end-to-side repair of either one or two recipient nerves, there was a recovery of toe spreading to 60-72% of the preoperative value (lowest value around 47%). Electrical stimulation of the end-to-side attached radial or median/ulnar nerves 6 months after repair resulted in contraction of muscles in the forearm innervated by these nerves (median tetanic muscle force up to 70% of the contralateral side). Retrograde labeling showed that both myelinated (morphometry) sensory and motor axons were recruited to the end-to-side attached nerve and that these axons emerged from the motor and sensory neuronal pool of the brachial plexus. Double retrograde labeling indicated that collateral sprouting was one mechanism by which regeneration occurred. We also found that two recipient nerves could be supported from a single donor nerve. Our results suggest that end-to-side repair may be one alternative to reconstruct a brachial plexus injury when no proximal nerve end is available

Orientando e incluyendo poblaciones vulnerabilizadas

El trabajo plantea una propuesta de orientación vocacional que se llevó a cabo en el Bachillerato Popular Trans género Mocha Cellis, en el año 2014. Es propósito promover la reflexión respecto de la población trans en términos de inclusión socio educativa y contribuir a la visibilización de las dificultades que atraviesa. Así mismo, la propuesta invita a los orientadores a la reflexión respecto de sus propias elecciones; de los modos de pensar a las poblaciones trans; y a asumir el diseño de abordajes orientadores éticos

Orientando e incluyendo poblaciones vulnerabilizadas : Proceso de Orientación Vocacional en el Bachillerato Popular Trans Género Mocha Cellis

El trabajo plantea una propuesta de orientación vocacional que se llevó a cabo en el Bachillerato Popular Trans género Mocha Cellis, en el año 2014. Es propósito promover la reflexión respecto de la población trans en términos de inclusión socio educativa y contribuir a la visibilización de las dificultades que atraviesa. Así mismo, la propuesta invita a los orientadores a la reflexión respecto de sus propias elecciones; de los modos de pensar a las poblaciones trans; y a asumir el diseño de abordajes orientadores éticos.Facultad de Psicologí