How Experiences Become Data: The Process of Eliciting Adverse Event, Medical History and Concomitant Medication Reports in Antimalarial and Antiretroviral Interaction Trials.

Accurately characterizing a drug's safety profile is essential. Trial harm and tolerability assessments rely, in part, on participants' reports of medical histories, adverse events (AEs), and concomitant medications. Optimal methods for questioning participants are unclear, but different methods giving different results can undermine meta-analyses. This study compared methods for eliciting such data and explored reasons for dissimilar participant responses. Participants from open-label antimalarial and antiretroviral interaction trials in two distinct sites (South Africa, n = 18 [all HIV positive]; Tanzania, n = 80 [86% HIV positive]) were asked about ill health and treatment use by sequential use of (1) general enquiries without reference to particular conditions, body systems or treatments, (2) checklists of potential health issues and treatments, (3) in-depth interviews. Participants' experiences of illness and treatment and their reporting behaviour were explored qualitatively, as were trial clinicians' experiences with obtaining participant reports. Outcomes were the number and nature of data by questioning method, themes from qualitative analyses and a theoretical interpretation of participants' experiences. There was an overall cumulative increase in the number of reports from general enquiry through checklists to in-depth interview; in South Africa, an additional 12 medical histories, 21 AEs and 27 medications; in Tanzania an additional 260 medical histories, 1 AE and 11 medications. Checklists and interviews facilitated recognition of health issues and treatments, and consideration of what to report. Information was sometimes not reported because participants forgot, it was considered irrelevant or insignificant, or they feared reporting. Some medicine names were not known and answers to questions were considered inferior to blood tests for detecting ill health. South African inpatient volunteers exhibited a "trial citizenship", working to achieve researchers' goals, while Tanzanian outpatients sometimes deferred responsibility for identifying items to report to trial clinicians. Questioning methods and trial contexts influence the detection of adverse events, medical histories and concomitant medications. There should be further methodological work to investigate these influences and find appropriate questioning methods

Civil society leadership in the struggle for AIDS treatment in South Africa and Uganda

Includes abstract.Includes bibliographical references.This thesis is an attempt to theorise and operationalise empirically the notion of ‘civil society leadership’ in Sub-Saharan Africa. ‘AIDS leadership,’ which is associated with the intergovernmental institutions charged with coordinating the global response to HIV/AIDS, is both under-theorised and highly context-specific. In this study I therefore opt for an inclusive framework that draws on a range of approaches, including the literature on ‘leadership’, institutions, social movements and the ‘network’ perspective on civil society mobilisation. This framework is employed in rich and detailed empirical descriptions (‘thick description’) of civil society mobilisation around AIDS, including contentious AIDS activism, in the key case studies of South Africa and Uganda. South Africa and Uganda are widely considered key examples of poor and good leadership (from national political leaders) respectively, while the Treatment Action Campaign (TAC) and The AIDS Support Organisation (TASO) are both seen as highly effective civil society movements. These descriptions emphasise ‘transnational networks of influence’ in which civil society leaders participated (and at times actively constructed) in order to mobilise both symbolic and material resources aimed at exerting influence at the transnational, national and local levels

Hubungan antara Tingkat Partisipasi dengan Hasil Belajar Peserta Pelatihan Pengembangan Kepribadian dan Kepemimpinan Mahasiswa Baru UMM Tahun 2005/2006

Sejak tahun akademik 2004/2005 Universitas Muhammadiyah Malang mewajibkan setiap mahasiswa barunya untuk mengikuti Pelatihan Pengembangan Kepribadian dan Kepemimpinan (P2KK). Pendekatan pembelajaran yang digunakan dalam pelatihan tersebut adalah pendekatan pembelajaran orang dewasa dengan metode experiential learning yang berpusat pada pesertanya. Tujuan penelitian ini adalah untuk memperoleh gambaran mengenai bagaimana hubungan antara tingkat partisipasi peserta dalam proses pembelajaran pada P2KK tahun 2005/2006 dengan pencapaian hasil belajarnya. Penelitian ini adalah penelitian korelasional non eksperimen. Variabel tingkat partisipasi diukur melalui observasi dan hasil belajar diukur melalui tes hasil belajar, metode analisis data dengan menggunakan uji statistik teknik uji korelasi Product-Moment dari Pearson. Hasil analisis menunjukkan adanya hubungan positif yang sangat signifikan antara tingkat partisipasi dengan hasil belajar (r = 0,320; p = 0,000) yang berarti bahwa semakin baik tingkat partisipasi semakin tinggi skor tes yang dicapai oleh peserta pelatihan. Dengan demikian hipotesis diterima

Minimum Benefits for HIV/AIDS in South African Medical Schemes

This paper provides the results of a survey of the structure of HIV/AIDS benefits in open and restricted medical schemes in South Africa in 2002. The results of the survey were used to develop a series of recommendations to the Minister of Health in respect of the extent of prescribed minimum benefits for HIV/AIDS. Medical schemes are required to provide the PMBs to their members without limits or co-payments. Keywords: Medical schemes; HIV; AIDS; benefits; prescribed minimum benefits South African Actuarial Journal: 2003 3: 77-11