HIV/AIDS is already the leading cause of death worldwide (Unicef et al., 2004:10) with more than 5 million people out of a total of 46 million South Africans that were HIV positive in 2004, giving a total population prevalence rate of 11 per cent (Dorrington et al., 2004:1). Many people infected do not have access to even the basic drugs needed to treat HIV-related infections and other conditions (Wikipedia, 2004:3). The relative high price of many of the antiretroviral (ARV) drugs and diagnostics on the other hand are one of the main barriers to their availability in developing countries (Unicef et al., 2004:77). ARV drugs registered in South Africa include the Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs), Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) and Protease Inhibitors (PIs) (MCC, 2004:1). The objective of this study was to review, analyse and interpret the prescribing patterns of antiviral drugs, with special reference to antiretroviral drugs, in the private health care sector in South Africa by using a medicine claims database. A quantitative, retrospective drug utilisation review was performed. The data ranging from 1 January 2001 to 31 December 2001, 1 January 2002 to 31 December 2002, and 1 January 2004 to 31 December 2004 were used, dividing each year into three four-month periods, namely January to April, May to August, and September to December. It was found that 0.38 per cent (n=1 475 380) for 2001, 0.72 per cent (n=2 076 236) for 2002, and 1.68 per cent (n=2 595 254) for 2004 of all studied prescriptions for the research periods 2001, 2002, and 2004 respectively, contained ARV drugs. ARV drugs constituted 0.33 per cent (n=2 951 326) for 2001, 0.87 per cent (n=4 042 145) for 2002, and 1.92 per cent (n=5 305 882) for 2004 of the total number of medicine items prescribed for the study years 2001, 2002 and 2004 respectively. The total cost of ARV drugs amounted to R4 990 784.29, thus constituting 1.31 per cent of the total cost (R379 708 489) of all medicine items on the database for 2001, increased to R18 235 075.75, thus constituting 3.03 per cent of the total cost (R601 350 325) of all medicine items on the database for 2002, and increased to R34 714 483.64, thus constituting 5.25 per cent of the total cost (R661 223 146) of all medicine items on the database for 2004. It was found that 35.31 per cent (n=5 599) for 2001, 52.68 per cent (n=15 004) for 2002, and 74.27 per cent (n=43 482) for 2004 of all studied antiviral prescriptions for the research periods 2001, 2002, and 2004 respectively, contained ARV drugs. ARV drugs constituted 46.25 per cent (n=21 183) for 2001, 70.20 per cent (n=50 246) for 2002, and 85.87 per cent (n=118 718) for 2004 of the total number of antiviral medicine items prescribed for the study years 2001, 2002 and 2004 respectively. The total cost of ARV medicine items, represented 67.33 per cent (n=R4 990 784.29) during 2001, 84.72 per cent (n=R18 235 075.75) during 2002, and 91.20 per cent (n=R34 714 483.64) during 2004 of the total cost of all antiviral medicine items claimed through the database (n=R7412577.73 for 2001, n=R21523365.56 for 2002, and n=R38 064 347.38 for 2004). The average cost per ARV medicine items for 2004 increased from R317.93i190.80 for the period January to April to R369.2W219.50 for the period May to August, and decreased to R324.79±212.48 for the period September to December and resulted in a cost saving of R41 044.35 for the period May to August versus September to December for the ARV medicine items. The implementation of the pricing regulations could thus be a possible reason for this cost saving, due to fact that the single exit price only came into effect from May 2004. The weighted average number of ARV medicine items per prescription was 1.75*0.31 for 2001, increased to 2.35±0.03 to 2002 and remained stable on 2.35±0.02 for 2004. It was found that majority of prescriptions contained more combination ARV medicine items than single ARV medicine items, ranging from 6 834 (69.76 per cent; n=9 796) prescriptions containing combination ARV medicine items in 2001 and 32 941 (93.39 per cent; n=35 271) prescriptions containing combination ARV medicine items in 2002 to 98 805 (96.93 per cent; n=101 938) prescriptions containing combination ARV medicine items in 2004. Lastly, it was perceived that didanosine was the active ingredient with the largest prevalence for all three four-month periods of 2001 and also for the periods January to April and May to August of 2002, whilst efavirenz represented the active ingredient with the largest prevalence for the period September to December of 2002, and also for all three four-month periods of 2004. Didanosine represented the active ingredient with the highest total cost for the period January to April of 2001, whilst the combination of lamivudine/zidovudine represented the active ingredient with the highest total cost for the periods May to August and September to December of 2001, and also for all three-four month periods of 2002 and 2004. Nelfinavir has the highest average cost for period January to April of 2001, ritonavir for period May to August of 2001, and saquinavir mesylate for period September to December of 2001. Nelfinavir has the highest average cost for all three-four month periods of 2002, while didanosine has the highest average cost for all three four-month periods of 2004. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2006

This text is an essay relating to a situation I was involved in where two different cultures caused a conflict in one of the pupils. The pupil was supposed to perform a swimming test and the parents wanted him/her to use full body clothing which the pupil had not done before. Because of this, the pupil suddenly was in conflict with herself/himself and I (the author) found myself in a situation where I felt torn between the purpose as an educator and the cultural values of the pupil. The purpose of my essay is to find an approach to the values of pupils and parents which sometimes affect my way of work. Our school curriculum states that we must prevent differences of gender but at the same time respect the culture of the individual. Several times I find myself trapped between cultural values from the pupil´s family situation and our educational purpose. How do I deal with this? How does switching between two cultures affect the pupil? The concept and perspectives that I am going to reflect on are interculturality, multi culturalism and I will also discuss heritage, environment, traditions, identity and the importance of the family. I will review myself and my own reflections. I will reflect upon how I use fronesis, my practical wisdom which I have gathered through experience. What can I improve when I use my professionalism within the cultural areas? Writing this essay, I still feel torn between the different missions. I always feel the need to act with the pupil´s best interest at heart. If this means I counteract gender patterns, so be it. In my opinion the culture doesn´t really matter because all individuals have the same value. The school simply cannot teach the pupils ethics and then not act accordingly themselves. / Den här texten är en essä och den utgår från en egen upplevd situation där två olika kulturer ger upphov till en konflikt hos en elev. Eleven ska utföra ett simtest och föräldrarna vill att hen skulle simma i heltäckande, vilket hen inte gjort tidigare. Det gjorde att eleven hamnade i en konflikt med sig själv och jag (författaren) hamnade i en situation där jag känner mig klämd mellan vad vårt uppdrag säger och elevens kulturella värderingar. Syftet med mitt arbete är att hitta ett förhållningssätt till elever och föräldrars värderingar som ibland påverkar mitt arbetssätt. I våra styrdokument står det att vi ska motverka könsskillnader, men samtidigt respektera individens kultur. Flera gånger ställs jag mellan vårt uppdrag och de kulturella värderingarna eleven har med sig hemifrån. Hur bemöter jag det? Hur upplever eleven det är att pendla mellan två olika kulturer? Begrepp och perspektiv jag kommer att reflekterar kring är interkulturalitet, mångkulturalitet och jag kommer även föra en diskussion kring arv, miljö, traditioner, identitet och familjens betydelse. Jag kommer granska mig själv och mitt eget reflekterande. Jag kommer använda mig av min fronesis, min praktiska klokhet som jag samlat på mig genom all erfarenhet. Vad är det jag kan bli bättre på i utförandet av min praktiska yrkeskompetens inom det kulturella området? Något jag kommit fram till i den här essän är, att känslan av att vara klämd mellan uppdragen kvarstår. Jag känner att jag alltid måste handla utifrån elevens bästa. Om det gör att jag motverkar att jag utjämnar könsmönster får det vara så. I mina ögon spelar kulturen ingen roll, alla individer är värda lika mycket, Vi i skolan kan inte lära ut värdegrunden till eleven, och sedan själva göra tvärtemot.

This study using a quantitative, descriptive design with a questionnaire investigated cultural, religious and social factors that might impact on ARV treatment in HIV/AIDS-infected women in Botswana. The study found that the majority never missed any doses, a few missed doses once or twice, and a small minority missed more than three times. The respondents’ perception of cultural influence on treatment of HIV/AIDS in women revealed that the majority (70%) believe culture has an influence on the treatment. Social factors also impacted on ARV adherence. A few of the respondents indicated that side effects and the number of pills prevented ARV medication adherence. The main reason for non-adherence, however, was forgetfulness. There had been an improvement in the majority of the respondents’ health status and quality of life. Maximizing adherence is essential. Providers and patients both have responsibilities in this regard. / Health Studies / M.A.(Health Studies)

Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2006.

<p>Antiretroviral regimens have side effects that can threaten adherence by patients resulting in evolution of viral resistance due to suboptimal drug levels. Studies have shown that drug adherence of at least 80% can result in viral load suppression. There is no literature on the association between the level of adherence to antiretroviral therapy and the degree of virological suppression in Namibia. The aim of the present study was to determine the therapeutic and virological outcomes in HIV/AIDS patients at 6 and 12 months after initiation of highly-active antiretroviral therapy (HAART) in an urban population in Namibia. The distribution of viral load results showed a low uptake (35%) of virological monitoring at 6 month time point and even lower (12%) at 12 months. A conservative viral load threshold for virological response is required in the Namibian setting. The current adherence level of &gt / 80% encourage increased ARV therapy rollout. Poor virological outcome was associated with self-reported adherence.</p>

In today’s society it is not uncommon for people to move across borders. We are more likely to work and study in other countries, initiate cross-border relationships, acquire property in other states and change our residence. Therefore it is not uncommon for a per-son to leave inheritance in several states. The laws of succession differ between countries which creates an uncertainty among the devisors when planning their successions. This un-certainty, to which court has jurisdiction and to which country’s law is applicable, is con-sidered as incompatible with the free movement of people and capital within the EU. Therefore, the EU regulation No 650/2012 has been introduced to reduce the uncertainty and enable the EU citizens to govern their successions in advance.The purpose of this paper is to examine whether the regulation solves the current problems regarding the court of jurisdiction and applicable law in cross-border situations concerning succession within the EU and how this regulation in these matters relate to third state. To answer the purpose of this paper the applicable law is studied from a problem-based per-spective. The sources of law is systematized, interpreted and defined in the paper with a descriptive method.The regulation states that the principle of domicile is to be used as a harmonizing principle both regarding jurisdiction and applicable law. The regulation however, does not provide a clear definition of the term domicile. The authors of this paper consider this to be a problem in the enforcement of the principle. The regulation has universal application, wherefore the court may have to apply another state’s law when judging the succession. In such situations it may, for several reasons, be difficult to maintain a high level of legal certainty. The regu-lation only binds the Member States but may still be beneficial in successions related to a third State. / I dagens samhälle är det vanligt att människor rör sig över landsgränserna. Gränsöverskri-dandeförhållanden inleds, allt fler personer arbetar och studerar utanför medborgarskaps-landet, de byter hemvist och förvärvar egendom i andra stater, vilket gör att det vid en per-sons bortgång inte är ovanligt att denne efterlämnar kvarlåtenskap i flera stater. Staters arvsrättsliga regler skiljer sig åt vilket skapar en osäkerhet hos arvlåtaren då denne ska pla-nera för sin kvarlåtenskap. Denna oförutsägbarhet, avseende främst vilken domstol som är behörig samt vilken lag som är tillämplig, har ansetts strida mot den fria rörligheten av människor och kapital inom EU. Därför har en EU-förordning, nr 650/2012 av den 4 juli 2012 om behörighet, tillämplig lag, erkännande och verkställighet av domar samt godkän-nande och verkställighet av officiella handlingar i samband med arv och om inrättandet av ett europeiskt arvsintyg, förhandlats fram för att minska osäkerheten och underlätta för EU:s medborgare att utforma sina arvsrättsliga förhållanden i förväg.Syftet med denna uppsats är att utreda huruvida förordning nr 650/2012 löser nuvarande problematik avseende domsrätts- och lagvalsfrågorna i gränsöverskridanade arvsituationer inom EU samt hur denna förordning i dessa frågor förhåller sig till tredjestat. För att be-svara syftet utreds gällande rätt ur en problemorienterad synvinkel. Rättskällorna systemati-seras och tolkas för att sedan framställas i uppsatsen med en deskriptiv metod.I förordningen anges hemvistprincipen som harmoniserande anknytningsprincip både av-seende domsrätt och lagval. Det anges dock ingen klar och tydlig definition av hemvistbe-greppet, vilket uppsatsförfattarna anser utgör ett problem vid tillämpningen av principen. Förordningen är universell varför den behöriga domstolen kan tvingas tillämpa en annan stats lag. I sådana situationer kan det av flera anledningar vara svårt att upprätthålla en hög rättsäkerhet. Förordningen binder endast unionens medlemsstater men kan ändå vara till fördel i arvsmål med anknytning till tredjestat.

<p>Antiretroviral regimens have side effects that can threaten adherence by patients resulting in evolution of viral resistance due to suboptimal drug levels. Studies have shown that drug adherence of at least 80% can result in viral load suppression. There is no literature on the association between the level of adherence to antiretroviral therapy and the degree of virological suppression in Namibia. The aim of the present study was to determine the therapeutic and virological outcomes in HIV/AIDS patients at 6 and 12 months after initiation of highly-active antiretroviral therapy (HAART) in an urban population in Namibia. The distribution of viral load results showed a low uptake (35%) of virological monitoring at 6 month time point and even lower (12%) at 12 months. A conservative viral load threshold for virological response is required in the Namibian setting. The current adherence level of &gt / 80% encourage increased ARV therapy rollout. Poor virological outcome was associated with self-reported adherence.</p>

The purpose of this study is to increase understanding of the unemployed youth. To achievethat, we have investigated who the unemployed young people are, how their wellbeing isaffected and what they need for a change to take place. The study was conducted in amedium-sized Swedish city with the help of a method combination. The target population forthis study is people enrolled in “Job-guarantee for Youth” in spring 2014. The quantitativepart of the study was conducted using questionnaires and qualitatively through interviewswith seven young people in the group. The result shows that the social heritage is reflected inwhich education the young people have chosen and what future plans they have. Furthermore,the study shows that mental health is affected. The economy as well. / Syftet med den här studien är att öka förståelsen för arbetslösa ungdomar. För att uppnå detsyftet har vi undersökt vilka de arbetslösa är, hur de mår och vad de behöver för att enförändring ska kunna ske. Studien genomfördes i en medelstor svensk stad med hjälp av enmetodkombination. Målgruppen för vår studie är personer inskrivna i ”jobbgaranti förungdomar” under våren 2014. Den kvantitativa delen i studien genomfördes med hjälp avenkäter och den kvalitativa med hjälp av intervjuer med sju berörda personer i gruppen.Resultatet visar att det sociala arvet avspeglar sig i vilken utbildning de unga har valt ochvilka framtidsplaner dem har. Dessutom visar studien att den psykiska hälsan påverkasnegativt. Ekonomin likaså.

HIV/AIDS is already the leading cause of death worldwide (Unicef et al., 2004:10) with more than 5 million people out of a total of 46 million South Africans that were HIV positive in 2004, giving a total population prevalence rate of 11 per cent (Dorrington et al., 2004:1). Many people infected do not have access to even the basic drugs needed to treat HIV-related infections and other conditions (Wikipedia, 2004:3). The relative high price of many of the antiretroviral (ARV) drugs and diagnostics on the other hand are one of the main barriers to their availability in developing countries (Unicef et al., 2004:77). ARV drugs registered in South Africa include the Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTIs), Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) and Protease Inhibitors (PIs) (MCC, 2004:1). The objective of this study was to review, analyse and interpret the prescribing patterns of antiviral drugs, with special reference to antiretroviral drugs, in the private health care sector in South Africa by using a medicine claims database. A quantitative, retrospective drug utilisation review was performed. The data ranging from 1 January 2001 to 31 December 2001, 1 January 2002 to 31 December 2002, and 1 January 2004 to 31 December 2004 were used, dividing each year into three four-month periods, namely January to April, May to August, and September to December. It was found that 0.38 per cent (n=1 475 380) for 2001, 0.72 per cent (n=2 076 236) for 2002, and 1.68 per cent (n=2 595 254) for 2004 of all studied prescriptions for the research periods 2001, 2002, and 2004 respectively, contained ARV drugs. ARV drugs constituted 0.33 per cent (n=2 951 326) for 2001, 0.87 per cent (n=4 042 145) for 2002, and 1.92 per cent (n=5 305 882) for 2004 of the total number of medicine items prescribed for the study years 2001, 2002 and 2004 respectively. The total cost of ARV drugs amounted to R4 990 784.29, thus constituting 1.31 per cent of the total cost (R379 708 489) of all medicine items on the database for 2001, increased to R18 235 075.75, thus constituting 3.03 per cent of the total cost (R601 350 325) of all medicine items on the database for 2002, and increased to R34 714 483.64, thus constituting 5.25 per cent of the total cost (R661 223 146) of all medicine items on the database for 2004. It was found that 35.31 per cent (n=5 599) for 2001, 52.68 per cent (n=15 004) for 2002, and 74.27 per cent (n=43 482) for 2004 of all studied antiviral prescriptions for the research periods 2001, 2002, and 2004 respectively, contained ARV drugs. ARV drugs constituted 46.25 per cent (n=21 183) for 2001, 70.20 per cent (n=50 246) for 2002, and 85.87 per cent (n=118 718) for 2004 of the total number of antiviral medicine items prescribed for the study years 2001, 2002 and 2004 respectively. The total cost of ARV medicine items, represented 67.33 per cent (n=R4 990 784.29) during 2001, 84.72 per cent (n=R18 235 075.75) during 2002, and 91.20 per cent (n=R34 714 483.64) during 2004 of the total cost of all antiviral medicine items claimed through the database (n=R7412577.73 for 2001, n=R21523365.56 for 2002, and n=R38 064 347.38 for 2004). The average cost per ARV medicine items for 2004 increased from R317.93i190.80 for the period January to April to R369.2W219.50 for the period May to August, and decreased to R324.79±212.48 for the period September to December and resulted in a cost saving of R41 044.35 for the period May to August versus September to December for the ARV medicine items. The implementation of the pricing regulations could thus be a possible reason for this cost saving, due to fact that the single exit price only came into effect from May 2004. The weighted average number of ARV medicine items per prescription was 1.75*0.31 for 2001, increased to 2.35±0.03 to 2002 and remained stable on 2.35±0.02 for 2004. It was found that majority of prescriptions contained more combination ARV medicine items than single ARV medicine items, ranging from 6 834 (69.76 per cent; n=9 796) prescriptions containing combination ARV medicine items in 2001 and 32 941 (93.39 per cent; n=35 271) prescriptions containing combination ARV medicine items in 2002 to 98 805 (96.93 per cent; n=101 938) prescriptions containing combination ARV medicine items in 2004. Lastly, it was perceived that didanosine was the active ingredient with the largest prevalence for all three four-month periods of 2001 and also for the periods January to April and May to August of 2002, whilst efavirenz represented the active ingredient with the largest prevalence for the period September to December of 2002, and also for all three four-month periods of 2004. Didanosine represented the active ingredient with the highest total cost for the period January to April of 2001, whilst the combination of lamivudine/zidovudine represented the active ingredient with the highest total cost for the periods May to August and September to December of 2001, and also for all three-four month periods of 2002 and 2004. Nelfinavir has the highest average cost for period January to April of 2001, ritonavir for period May to August of 2001, and saquinavir mesylate for period September to December of 2001. Nelfinavir has the highest average cost for all three-four month periods of 2002, while didanosine has the highest average cost for all three four-month periods of 2004. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2006

Thesis (MMed) -- Stellenbosch University, 2010. / Bibliography / Objective: The objective of this retrospective cohort study is to assess whether demographic and anthropometric parameters, laboratory tests, co-morbidity, co-infection, treatment regimen, IRIS and adherence to treatment predict the expected response to HAART and differences if any, in the pattern of response as measured by CD4 count, weight gain and haemoglobin levels in two cohorts of patients in Roma, The Kingdom of Lesotho. Method: Data were collected randomly from a computerised database of the Antiretroviral Centre of the hospital and two cohorts of 151 subjects in each of the two arms of the study were identified from hospital records from January 2008. Each of these subjects was followed up over a period of 12 months with data obtained for at least 2 visits within the 12 month span. Data were obtained at baseline, 3 months and also at 6 and 12 months marks. Data on characteristics were compared between the two arms. Variables that may be potential confounders were identified and univariate and multivariate logistic regression analyses were carried out to establish differences independent of confounding factors for the combined endpoints as well as for each endpoint separately. Results: In all 302 patients had their records analysed and comparison of clinical and immunological response patterns in patients taking AZT and TDF-containing ART regimens and the possible prediction of which the regimen would be better and within which population. Despite the perceived mismatch between two NRTIs it can be concluded from the results of this study that, overall, the inclusion of AZT in treatment regimen showed a modest protective effect over the TDF counterpart as measured by the endpoints of the discriminative powers of the Receiver Operating Curves of the explanatory variables being 66% , 77% and 66% for CD4, Haemoglobin and Weight respectively, and 63%, 70% and 65% for the same variables in the AZT and TDF arms of the study respectively. Conclusion: In a population of HIV patients on treatment in resource-limited settings AZT-containing regimens appear to show a slight improvement over the TDF-containing ones.