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The emotional aspect of caregiving is extremely complex and caregivers face tremendous emotional challenges as they react to the reality of their loved one's increasing disability. When it comes to making the placement decision, caregivers have frequently reached a burnout point in making decisions.

Indiana University-Purdue University Indianapolis (IUPUI) / Polypharmacy is a general clinical practice, there is a high chance that multiple administered drugs will interfere with each other, such phenomenon is called drug-drug interaction (DDI). DDI occurs when drugs administered change each other's pharmacokinetic (PK) or pharmacodynamic (PD) response. DDIs in many ways affect the overall effectiveness of the drug or at some times pose a risk of serious side effects to the patients thus, it becomes very challenging to for the successful drug development and clinical patient care. Biomedical literature is rich source for in-vitro and in-vivo DDI reports and there is growing need to automated methods to extract the DDI related information from unstructured text. In this work we present an ontology (PK ontology), which defines annotation guidelines for annotation of PK DDI studies. Using the ontology we have put together a corpora of PK DDI studies, which serves as excellent resource for training machine learning, based DDI extraction algorithms. Finally we demonstrate the use of PK ontology and corpora for extracting PK DDIs from biomedical literature using machine learning algorithms.

Indiana University-Purdue University Indianapolis (IUPUI) / Alzheimer's disease (AD) is a neurodegenerative disorder characterized by gradual loss of brain functions, usually preceded by memory impairments. It has been widely affecting aging Americans over 65 old and listed as 6th leading cause of death. More importantly, unlike other diseases, loss of brain function in AD progression usually leads to the significant decline in self-care abilities. And this will undoubtedly exert a lot of pressure on family members, friends, communities and the whole society due to the time-consuming daily care and high health care expenditures. In the past decade, while deaths attributed to the number one cause, heart disease, has decreased 16 percent, deaths attributed to AD has increased 68 percent. And all of these situations will continue to deteriorate as the population ages during the next several decades. To prevent such health care crisis, substantial efforts have been made to help cure, slow or stop the progression of the disease. The massive data generated through these efforts, like multimodal neuroimaging scans as well as next generation sequences, provides unprecedented opportunities for researchers to look into the deep side of the disease, with more confidence and precision. While plenty of efforts have been made to pull in those existing machine learning and statistical models, the correlated structure and high dimensionality of imaging and genetics data are generally ignored or avoided through targeted analysis. Therefore their performances on imaging genetics study are quite limited and still have plenty to be improved. The primary contribution of this work lies in the development of novel prior knowledge-guided regression and association models, and their applications in various neurobiological problems, such as identification of cognitive performance related imaging biomarkers and imaging genetics associations. In summary, this work has achieved the following research goals: (1) Explore the multimodal imaging biomarkers toward various cognitive functions using group-guided learning algorithms, (2) Development and application of novel network structure guided sparse regression model, (3) Development and application of novel network structure guided sparse multivariate association model, and (4) Promotion of the computation efficiency through parallelization strategies.

The aim of this qualitative study was to understand how older women experience their roles as care-givers to HIV/AIDS affected households in the Atteridgeville community and to identify specific problems they encounter. Twelve older women attending three elderly day care centres in Atteridgeville participated in the study. Purposive sampling was done and data was collected through two focus group interviews. Colaizzi‟s seven-step method of data analysis yielded the following four main themes: Caring for adult children with HIV/AIDS, Caring for HIV affected and infected grandchildren, Multiple role players involved in caring for HIV/AIDS persons, The impact on the lives of care-givers. Factors with a positive and negative impact on caring for HIV/AIDS households were identified. The study raises awareness for the need for social workers in Atteridgeville to intervene in assisting older women in their challenging role of caring for HIV/AIDS households / Health Studies / M.A. (Public Health)

Text in English / The discovery that anti-retroviral therapy (ART) is important for human immunodeficiency syndrome (HIV) prevention has increased interest in factors that influence adherence to HIV treatment. Studies have shown that non-adherence to ART results in drug resistance, morbidity and person-to-person HIV transmission. For persons defaulting on or living risky sexual lives, becoming adherent is a life-saving behavioural change, both for themselves and for their sexual partners. HIV/AIDS programmes are trying different innovations to enhance behavioural outcomes of people living with HIV (PLHIV). This study sought to determine the value of support group participation and based on the findings, to develop an evidence-based model for revitalising caregiver social support competencies. The study was conducted in two phases. In the first phase, a cross-sectional descriptive design was used to compare PLHIV who participate in support group activities with those who do not, in terms of their behavioural outcomes. Multistage probability sampling was used to select study respondents. Data was collected using a selfadministered questionnaire from 1,676 respondents between February and May 2014. Data was analysed using STATA. Data analysis shows that 47% of respondents had once (ever) participated in support group activities while 53% had never. PLHIV who participated in support group activities differed from those who did not in terms of HIV-related stigma (p=<0.001), positive HIV status disclosure (p=0.005), ART adherence (p=0.021), and sexual risk behaviours (p=0.045). PLHIV who participated in support group activities were more likely to have less internal HIV-related stigma, disclose their positive HIV status, adhere to ART and live less risky sexual lives. The two study groups were not different in terms of perceived social support (p=0.28) and external stigma (p=0.250). More PLHIV obtained social support from health workers (66%) and family members (36%) than from PLHIV support groups (16%). The researcher concludes that participating in support group activities positively impacts on behavioural outcomes of PLHIV, but PLHIV support groups are not the only sources of social support. In the second phase, a model for revitalising PLHIV caregiver social support competencies was developed as a recommendation for assuring PLHIV access to holistic care and support. / Health Studies / D. Litt. et Phil. (Health Studies)

Evidence suggests that caring for orphans and vulnerable children affected by HIV and AIDS remains one of the greatest challenges facing South Africa. Statistics indicate that there are 1.91 million AIDS orphans in the country (UNICEF, 2012; Statistics South Africa, 2009:8)). The majority of these orphans live in rural and poor urban households. Caring for orphans and vulnerable children places severe strain on support systems, such as the extended family; this spills over into the community. Providing care and support also places an extra burden on the already overstretched welfare sector and drains state resources. The primarily objective of this study was to explore community resilience strategies on challenges faced by orphans and vulnerable children affected by HIV and AIDS in Ekurhuleni Metropolitan Municipality, Gauteng. A purposive sample of 32 participants was selected and field data were collected over a period of two months using a structured research guide. A combination of data collection methods was employed in order to explore different perspectives of community resilience strategies on challenges faced by orphans and vulnerable children affected by HIV and AIDS in Benoni. Emerging data illustrate a clear account on the impact of the AIDS epidemic in Benoni. All of the respondents were directly or indirectly affected by the epidemic. This should be located within the high prevalence of HIV and AIDS and the high number of orphans in Ekurhuleni. The study findings further suggest a correlation between socioeconomic challenges and the AIDS epidemic in Ekurhuleni. This is demonstrated through the challenges experienced by orphans and vulnerable children in Benoni, which include: non-disclosure by parents of their illness; economic deprivation and disrupted schooling; children caring for an ill parent with AIDS and child-headed households; emotional, sexual and economic exploitation, stigmatisation and discrimination. Despite these challenges, through community resilience the Benoni community has taken some initiatives to mitigate against these challenges. This includes the establishment of a community based organisation which provides basic services to orphans and vulnerable children in Benoni. To date this organisation has successfully provided material and psychosocial to more than 278 orphans. The success of this initiative confirms the importance of community driven interventions using the resilience framework to supports orphans and vulnerable, rather than dependency on the government imposed programmes- top down approach. However, community based programmes need to be strengthened by the government and non-governmental organisations in order to maximise benefits. / Psychology / M.A. (Social Behaviour Studies)

The aim of this qualitative study was to understand how older women experience their roles as care-givers to HIV/AIDS affected households in the Atteridgeville community and to identify specific problems they encounter. Twelve older women attending three elderly day care centres in Atteridgeville participated in the study. Purposive sampling was done and data was collected through two focus group interviews. Colaizzi‟s seven-step method of data analysis yielded the following four main themes: Caring for adult children with HIV/AIDS, Caring for HIV affected and infected grandchildren, Multiple role players involved in caring for HIV/AIDS persons, The impact on the lives of care-givers. Factors with a positive and negative impact on caring for HIV/AIDS households were identified. The study raises awareness for the need for social workers in Atteridgeville to intervene in assisting older women in their challenging role of caring for HIV/AIDS households / Health Studies / M. A. (Public Health)

Text in English / The discovery that anti-retroviral therapy (ART) is important for human immunodeficiency syndrome (HIV) prevention has increased interest in factors that influence adherence to HIV treatment. Studies have shown that non-adherence to ART results in drug resistance, morbidity and person-to-person HIV transmission. For persons defaulting on or living risky sexual lives, becoming adherent is a life-saving behavioural change, both for themselves and for their sexual partners. HIV/AIDS programmes are trying different innovations to enhance behavioural outcomes of people living with HIV (PLHIV). This study sought to determine the value of support group participation and based on the findings, to develop an evidence-based model for revitalising caregiver social support competencies. The study was conducted in two phases. In the first phase, a cross-sectional descriptive design was used to compare PLHIV who participate in support group activities with those who do not, in terms of their behavioural outcomes. Multistage probability sampling was used to select study respondents. Data was collected using a selfadministered questionnaire from 1,676 respondents between February and May 2014. Data was analysed using STATA. Data analysis shows that 47% of respondents had once (ever) participated in support group activities while 53% had never. PLHIV who participated in support group activities differed from those who did not in terms of HIV-related stigma (p=<0.001), positive HIV status disclosure (p=0.005), ART adherence (p=0.021), and sexual risk behaviours (p=0.045). PLHIV who participated in support group activities were more likely to have less internal HIV-related stigma, disclose their positive HIV status, adhere to ART and live less risky sexual lives. The two study groups were not different in terms of perceived social support (p=0.28) and external stigma (p=0.250). More PLHIV obtained social support from health workers (66%) and family members (36%) than from PLHIV support groups (16%). The researcher concludes that participating in support group activities positively impacts on behavioural outcomes of PLHIV, but PLHIV support groups are not the only sources of social support. In the second phase, a model for revitalising PLHIV caregiver social support competencies was developed as a recommendation for assuring PLHIV access to holistic care and support. / Health Studies / D. Litt. et Phil. (Health Studies)

The US Bureau of the Census (1999) projected that by 2004, 14 million people in sub-Saharan Africa will develop full blown AIDS, making this region by far the largest disease burden in the world (World Health Organization, 2002). The United Nations AIDS Programme judged South Africa to have the leading number of people living with HIV/AIDS worldwide (World Health Organisation, 2002). To date there has been extensive research conducted on the socio-economic impacts of HIV/AIDS on families in Africa. However an area of investigation that has remained largely underreported is the inquiry into the psychological impacts of HIV/AIDS on elderly caregivers. In African families older women increasingly have to provide care to their adult children with AIDS and their orphaned grandchildren. However few research studies have assessed the experience of parental caregiving and its psychological impacts on these women. This qualitative research study hypothesised that the role of primary parental caregiver in fact causes a range of psychologically distressing states, which serve to compromise the psychological well-being of these caregivers. To investigate this hypothesis three Xhosa speaking women living in informal settlements in Grahamstown, in the Eastern Cape Province of South Africa were selected for the study. The women were interviewed by means of semi-structured interviews, which consisted of questions related to their caregiving experiences, their experiences of loss, their choice of coping strategies, the role of support networks and their experiences of foster care responsibilities. The interviews were transcribed and analysed using a grounded hermeneutic approach. The research results confirmed the working hypothesis. The research revealed that although it was considered culturally appropriate for older women to care for their children and grandchildren, their caregiver roles caused significant psychological distress. Their distress was related to: emotional and physical exhaustion, complicated grief reactions and ongoing emotional and physical upheaval related to foster care responsibilities. Based on the results, the research recommendations emphasised the need for continual awareness of the psychological implications of caregiving for older African women with the aim to preserve their capacity to function as the primary caring resource to families struck by HIV/AIDS.