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The roll-out of antiretroviral drugs in South Africa started in March 2004. In Mopani district, a rural district of Limpopo Province, the roll-out programme commenced in October 2004. While many resources were invested in this program, no study has assessed the clinical outcomes in this rural district. In addition, most studies conducted in South Africa were conducted in urban and tertiary settings. Assessing clinical outcomes is important in determining whether the program is making the desired clinical difference in the lives of the patients and may serve as feedback into the program for quality improvement purposes. Methodology The study was a retrospective record review of patients who were initiated on antiretroviral (ARV) treatment between December 2007 and November 2008. A structured questionnaire was used to collect data from 124 patient’s files and data was collected up to November 2011. The data collected included patients’ socio-demographic characteristics, clinical outcomes (CD4 count, viral load, presence of opportunistic infections, adverse effects and hospital admissions recorded at 6, 12, 24 and 36 months), the number of patients who were still attending the ARV clinic at 36 months and the reasons why patients are no longer attending the clinic. Data was analysed with Epi-Info and STATA. Results Of the 124 patients, 69% were females, 28% males and 3% did not have their sex specified. The majority of the patients were between 30 and 49 years. There was a significant improvement in CD4 count and viral load between baseline and all timeperiods after the initiation of ARV treatment. The mean CD4 count at baseline was 128The roll-out of antiretroviral drugs in South Africa started in March 2004. In Mopani district, a rural district of Limpopo Province, the roll-out programme commenced in October 2004. While many resources were invested in this program, no study has assessed the clinical outcomes in this rural district. In addition, most studies conducted in South Africa were conducted in urban and tertiary settings. Assessing clinical outcomes is important in determining whether the program is making the desired clinical difference in the lives of the patients and may serve as feedback into the program for quality improvement purposes. Methodology The study was a retrospective record review of patients who were initiated on antiretroviral (ARV) treatment between December 2007 and November 2008. A structured questionnaire was used to collect data from 124 patient’s files and data was collected up to November 2011. The data collected included patients’ socio-demographic characteristics, clinical outcomes (CD4 count, viral load, presence of opportunistic infections, adverse effects and hospital admissions recorded at 6, 12, 24 and 36 months), the number of patients who were still attending the ARV clinic at 36 months and the reasons why patients are no longer attending the clinic. Data was analysed with Epi-Info and STATA. Results Of the 124 patients, 69% were females, 28% males and 3% did not have their sex specified. The majority of the patients were between 30 and 49 years. There was a significant improvement in CD4 count and viral load between baseline and all timeperiods after the initiation of ARV treatment. The mean CD4 count at baseline was 128 The roll-out of antiretroviral drugs in South Africa started in March 2004. In Mopani district, a rural district of Limpopo Province, the roll-out programme commenced in October 2004. While many resources were invested in this program, no study has assessed the clinical outcomes in this rural district. In addition, most studies conducted in South Africa were conducted in urban and tertiary settings. Assessing clinical outcomes is important in determining whether the program is making the desired clinical difference in the lives of the patients and may serve as feedback into the program for quality improvement purposes. Methodology The study was a retrospective record review of patients who were initiated on antiretroviral (ARV) treatment between December 2007 and November 2008. A structured questionnaire was used to collect data from 124 patient’s files and data was collected up to November 2011. The data collected included patients’ socio-demographic characteristics, clinical outcomes (CD4 count, viral load, presence of opportunistic infections, adverse effects and hospital admissions recorded at 6, 12, 24 and 36 months), the number of patients who were still attending the ARV clinic at 36 months and the reasons why patients are no longer attending the clinic. Data was analysed with Epi-Info and STATA. Results Of the 124 patients, 69% were females, 28% males and 3% did not have their sex specified. The majority of the patients were between 30 and 49 years. There was a significant improvement in CD4 count and viral load between baseline and all timeperiods after the initiation of ARV treatment. The mean CD4 count at baseline was 128 cells/mm3; it increased to 310 cells/mm3 at 6 months, 380 cells/mm3 at 12 months and 470 cells/mm3 at 24 months. By 6 months, 67% of the patients had achieved viral suppression, but at 24 months, patients started having viral rebound. During the study, 20 patients fell pregnant and four patients fell pregnant twice. Overall, pregnant patients had a significantly higher viral load compared to non-pregnant patients (p-values = 0.015 at 6 months, 0.002 at 12 months and 0.027 at 24 months). Seventy two percent of patients were retained in the program at 36 months. Of the 28% that were no longer attending the clinic, 11.3% were transferred to other institutions, 6.5% were down referred to clinics, 3.2% died, 3.2% defaulted and 3.2% were lost to follow-up. Conclusion This study shows that good clinical outcomes can be achieved within an antiretroviral rollout program in a rural hospital. The biggest magnitude of clinical benefits was observed in the first six months after the initiation of ARV treatment with threats of viral rebound thereafter. There was good patient retention at 36 months after initiation of ARV treatment and a significant difference in viral load between pregnant and non-pregnant patients. The high rate of unplanned pregnancy signifies the need to place closer attention to family planning among female patients on antiretroviral treatment.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Currently, due to the existing potential regarding technology in the provision of services, the Peruvian government has developed solutions for its inhabitants. A survey conducted by the United Nations in 2016 endorses this fact, showing a high rate of technological development with respect to e-government. However, the same publication showed the low rate of citizen participation about it. These results show how, although there are many government technological services, these do not focus on the citizen or in their active participation, but mainly on technological development. In the present study, an adoption model is proposed, extending the Technology Acceptance Model (TAM) incorporating public value, specifically environmental sustainability, as an external variable. The validation of the proposal was made through a validated survey with experts in the environmental field and applied to citizens of the Peruvian capital. Our results show that environmental sustainability is a factor that positively affects the adoption of e-government in Peru and that should be considered by the authorities as an enhancer of citizen participation about it.

Purpose: Low citizen adoption rates jeopardize the success and proliferation of e-government systems. This study aims to understand how the perception of environmental sustainability (ES) can influence a citizen’s intention to use e-government systems. Design/methodology/approach: In a case study in Peru, the technology acceptance model (TAM) adoption model is extended with the construct of ES and evaluated with structural equation modeling. An 18-element, in-person survey was constructed and administered to citizens of Lima, Peru who had prior exposure to e-government systems. Findings: The results show that citizens can be positively influenced to adopt e-government systems if they perceive that doing so will contribute to ES. Research limitations/implications: As this was a preliminary study, further research should focus on specific, as opposed to general, e-government systems, as well as encompassing a broader cross section of the population. Practical implications: Administrators of e-government initiatives can consider public-interest factors, alongside of the common self-interest factors, when looking to improve adoption rates of e-government systems. Originality/value: This is the first time that TAM has been extended with the construct of ES.

Human valuing is a topic of study in many disciplines concerned with the behavior of humans in terms of its relationship to individual as well as group behavior. Many disciplines provide a theory of how values effect behavior, however a behavior analytic approach may demonstrate utility in terms of both understanding the formation of values as well as procedures that incorporate valuing into interventions for common psychological problems. Relational Frame Theory (RFT), a psychological account of human language and cognition, which has its foundation in behavior analysis, may provide an empirically-valid account of the formation of values and the mechanisms though which it effects behavior. Language processes including hierarchical, or categorical, relational responding, the transformation of consequential stimulus function, and rule-governed behavior may contribute to the act of human valuing. Acceptance and Commitment Therapy (ACT), a clinical derivative of RFT, incorporates values as a central component of treatment. This series of three studies sought to add to the empirical understanding of human valuing through two basic and one translational study. Study 1 examined the transformation of consequential stimulus functions in accordance with hierarchical networks, completed in a multiple baseline design. Results of this study suggest that, given sufficient strength of derived relations, the transformation was demonstrated by five of six participants. Study 2 evaluated the motivative effect of stimuli in a hierarchical relational network, completed in a multiple baseline design. The results suggest that in the presence of directly trained stimuli the motivative augmentals did not influence responding for four of four participants, however they did in a novel context for three of three participants. Study 3 sought to measure the effect of an arbitrary symbol related to a values-focused hierarchy as a motivative augmental for academic performance with a sample of undergraduate university students in a classroom setting. Together, these studies reflect a number of the languages processes necessary if an RFT-focused conceptualization of human valuing is accurate.

Applied Behavior Analysis has experienced an increase need for practitioners at all certification levels. Most recently, a demand for the paraprofessional-level certification, the Registered Behavior Technician™ (RBT®), is being driven by state licensure and health insurance reform. This has subsequently led to pressure to quickly train paraprofessionals to work with at-need clients. While this growth is favorable for the field it means that agencies are often at odds with balancing quality and breadth of knowledge, which can negatively impact clients’ lives. Furthermore, outside of basic minimum training standards, the behavior analytic governing bodies do not currently regulate RBT trainings the way they do for higher levels of certification, leaving it up to training supervisors to determine competency. In a series of experiments, some of the concerns with respect to RBT training will be addressed. The first will determine if an online curriculum is feasible for training RBT candidates to a level of proficiency for conceptual and practical knowledge. The second thread of research will examine if Acceptance and Commitment Training can lead to gains in RBT performance. Implications for the findings as well as future directions are discussed.

The science of psychotherapy is reliant on various research designs to provide evidence for and bolster the efficacy of therapeutic interventions, techniques, and packages. Among the therapeutic orientations with ample evidence of support is Acceptance and Commitment Therapy (ACT; Hayes et al., 1999). The creators of ACT propose targeting psychological flexibility, broadly defined as engaging with personal values with no regard of the presence of unwanted and undesired experiences. The Life Skills Modules protocol was developed to provide graduate student trainees with a simple and accessible tool to provide effective ACT treatment clients from the local community seeking treatment at the Southern Illinois University Clinical Center. The results of the study indicates that the clients improved in psychological flexibility, inflexibility, and symptoms of anxiety and depression, though this improvement is not explained by number of sessions nor completion of the protocol. Additionally, improvement in flexibility and inflexibility accounted for a significant portion of the variance in the improvement in symptoms as well. Flourishing did not improve within the clients. This study, while being marred with significant limitations, supports the ACT model of change of targeting psychological flexibility and inflexibility as being important towards improvement in treatment. The results of the study do not indicate the use of the protocol is the explicit cause of improvement. Discussion of the results and limitations are provided.

The technology and telecommunication industries have made significant progress in the past few decades leading to several inventions and designs that have significantly improved efficiency in all aspects of human life. These innovations in science and technology improve our quality of life. Modern technology enables us to access vast amounts of information and services through a network of interconnected computers and machines. Recently, various technologies have been proposed to incorporate the human body into this incorporated network. One of these proposed technologies are chip implants meant to be inserted into the human body at various suitable body parts, such as the human brain or wrist. As they are a relatively recent technological innovation, chip implants are neither popular nor common yet (Caldera, 2020; Michael et al., 2017). Previous research on chip implants has produced limited information regarding the motivation aspects of using this technology. So, this study uses a self-determination theory to see which motivational factors lead to the use and trust of chip implants. This thesis discusses how implantable technology works, to explore which factors affect an individual's willingness to get a chip implant, personality traits associated with implant adoption, motivational factors affecting adoptions, and other user-centered perspectives of the technology.