<p>Background: The Baby Friendly Hospital Initiative (BFHI) is considered one of the most successful international efforts to protect, promote and support breastfeeding. The initiative has proven impact, increasing the likelihood of babies being exclusively breastfed for six months. Official designation as Baby Friendly requires careful assessment completed by a trained external team to confirm that the institution is truly carrying out all Ten Steps of successful breastfeeding and conforming to the International Code of Marketing of Breastmilk Substitutes (BMS).The implementation of these principles are however challenging for facilities as it requires &ldquo / strategic planning, implementation and maintaining change&rdquo / within the facilities. Aim: To assess the factors influencing the implementation of BFHI principles in non accredited MOU` s in the Metropole region of the Western Cape.</p>

Anal cancer, like cervical cancer, is associated with Human Papillomavirus (HPV) infection. HIV+ patients have 38-60 fold increased risk of anal cancer compared to HIV- patients prompting many to suggest routine screening given the success of cervical Pap screening. Our goal is to describe our experience with routine anal Pap screening, determine which patients are most likely to have abnormal results, if anal disease on physical exam is predictive of cytology, and correlate cytology with histology findings. Charts of all patients with an anal Pap followed at the Hospital of Saint Raphael HIV Clinic were reviewed. Demographics, immune status, sexually transmitted disease history, cytology and histology data was extracted from medical charts. Patients with an anal Pap between November 1, 2002-November 30, 2004 were included. Those with an insufficient sample were excluded. Analysis was done using ÷2 for comparison of proportions and student t-test for continuous variables. Overall, 265/560 HIV+ patients had at least one anal Pap. Seventy-four of these 265 patients had an abnormal anal Pap. Mean age was 44 yrs, and 68% were men. Fifty-nine percent were African American, 34% White, and 17% Hispanic. Those with an abnormal Pap were more likely to be White (p=.03), and be gay or bisexual men (p=.02). They were also more likely to have lower CD4+ nadir (142 vs 223, p=.005) and CD4+ at time of anal Pap (353 vs 497, p<.001). Those with an abnormal anal Pap also had more anal disease (30% vs 9%, p<.001), history of warts (23% vs 12%, p=.02) and herpes (35% vs 22%, p=.02). Anal disease on physical exam had a sensitivity of 56% and specificity of 77% for abnormal cytology findings. On histology two patients had Anal Intraepithelial Neoplasia (AIN ) I, 2 AIN II, 3 AIN III, and 2 Squamous Cell Carcinoma In Situ. There was no correlation between cytology and histology. Routine anal cytology screening is a feasible tool to incorporate into an ethnically diverse HIV clinic for identifying precancerous anal lesions, a group which has been largely overlooked. Anal disease on physical exam is a poor predictor of abnormal cytology and there was no correlation between severity of disease on cytology and histology. However, further follow-up study is required to determine the impact on morbidity and mortality.

<p>Peripheral neuropathy (PN) is a common neurological complication occurring in the asymptomatic and symptomatic stages of human immune deficiency virus (HIV) infection. The pain and other symptoms caused by PN can impair functional ability and limit physical activity that could affect quality of life (QoL). Additionally, studies done on quality of life of people living with HIV/AIDS have shown that, HIV-related neurological syndromes, including PN, significantly reduce QoL. The aim of this study was to determine the prevalence of peripheral neuropathy amongst and the quality of life of adults living with HIV/AIDS attending the out-patient clinic at Rutongo Hospital in Rulindo District in Rwanda.</p>

<p>Background: The Baby Friendly Hospital Initiative (BFHI) is considered one of the most successful international efforts to protect, promote and support breastfeeding. The initiative has proven impact, increasing the likelihood of babies being exclusively breastfed for six months. Official designation as Baby Friendly requires careful assessment completed by a trained external team to confirm that the institution is truly carrying out all Ten Steps of successful breastfeeding and conforming to the International Code of Marketing of Breastmilk Substitutes (BMS).The implementation of these principles are however challenging for facilities as it requires &ldquo / strategic planning, implementation and maintaining change&rdquo / within the facilities. Aim: To assess the factors influencing the implementation of BFHI principles in non accredited MOU` s in the Metropole region of the Western Cape.</p>

With great appreciation, I would like to accentuate the substantial contributions of the following people who made this project possible: To Dr. CMT Fourie (my supervisor), Prof. JM van Rooyen (my co–supervisor) and Prof. AE Schutte (my co–supervisor) whose gracious advise, patient guidance, commitment and support have enabled me to plan, analyse, interpret and write this project in a scientific manner. It has been an educational experience for me, thank you. To Mr. LS Wyldbore for the language editing of this dissertation. I thank all the participants, researchers, field workers and supporting staff of the PURE study. The financial assistance of the National Research Foundation (DAAD–NRF) towards this research is hereby acknowledged. A special thanks to my parents, sister, Albert, family and friends, thank you for the never–ending love, support, patience and understanding that you gave me throughout this project. Last, but not the least, a special thank to God for giving me the opportunity, talent, determination and endurance to complete this project. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

HIV/AIDS is one of the largest health problems the world is currently facing. Even with anti-retroviral therapies (ART), many resource-constrained countries are unable to meet the treatment needs of their infected populations. ART-distribution methods need to be created that prevent the largest number of future HIV infections. We have developed a compartment model that tracks the spread of HIV in multiple two-sex populations over time in the presence of limited treatment. The model has been fit to represent the HIV epidemic in rural and urban areas in Uganda. With the model we examine the spread of HIV among urban and rural regions and observe the effects of preferential treatment to rural areas on the spread of HIV in the country as a whole. We also investigate the effects of preferentially treating women on the spread of HIV. We find that preferentially treating urban women produces the most dramatic effect in reducing the number of infected male and females in rural and urban areas.

With great appreciation, I would like to accentuate the substantial contributions of the following people who made this project possible: To Dr. CMT Fourie (my supervisor), Prof. JM van Rooyen (my co–supervisor) and Prof. AE Schutte (my co–supervisor) whose gracious advise, patient guidance, commitment and support have enabled me to plan, analyse, interpret and write this project in a scientific manner. It has been an educational experience for me, thank you. To Mr. LS Wyldbore for the language editing of this dissertation. I thank all the participants, researchers, field workers and supporting staff of the PURE study. The financial assistance of the National Research Foundation (DAAD–NRF) towards this research is hereby acknowledged. A special thanks to my parents, sister, Albert, family and friends, thank you for the never–ending love, support, patience and understanding that you gave me throughout this project. Last, but not the least, a special thank to God for giving me the opportunity, talent, determination and endurance to complete this project. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2012.

Bakgrund: Personer med HIV föreligger ökad risk för olika infektioner på grund av deras låga immunförsvar. Omvårdnadsbehov för personer med HIV kan vara munhälsa, nutrition och psykiskt stöd. Det förekommer att vårdpersonal har otrevlig attityd mot personer med HIV och låg kunskapsnivå om sjukdomen. Syfte: Syftet med denna litteraturöversikt var att belysa hur personer med HIV upplever hälso- och sjukvården. Metod: En litteraturöversikt där elva vetenskapliga artiklar har sammanställts. Resultat: Resultatet presenteras i fyra huvudteman: Mötet med vårdpersonal, Stöd och kunskap och Smitta och sekretessbrott, Andra instanser och aspekter som inverkade på upplevelsen av hälso- och sjukvården. Diskussion: Diskussionen belyser hur patienter med HIV upplevde bemötande från vårdpersonalen och hur vårdpersonalens kunskapsnivå kan påverka bemötandet, samt att patienterna upplever att de har en kunskapsbrist om HIV. Resultatet diskuteras med hjälp av vetenskapliga artiklar och Katie Erikssons teori om ansa, leka och lära samt begreppet vårdlidande. Det har betydelse att utföra vårdhandlingar utifrån patientens behov för att minska vårdlidande. / Background: People with HIV has an increased risk of various infections due to their low immune system. Care needs for people with HIV can be a good oral health, nutrition and psychological support. Healthcare professionals can have a bad attitude towards people with HIV and low levels of knowledge about the disease. Aim: The purpose of this literature review was to illuminate how people with HIV experience the healthcare. Method: A literature review with eleven scientific articles have been compiled. Results: The result is presented in four main themes: Meeting with healthcare professionals, Support and knowledge and Contagion and confidentiality, Other instances and aspects that affected the experience of healthcare. Discussion: The discussion illustrates how patients with HIV experienced treatment from the healthcare staff and how the healthcare staff's level of knowledge can affect the treatment, and that patients experience a lack of knowledge about HIV. The key parts of the result were discussed with help of scientific articles and Katie Eriksson´s theory of tending, playing and teaching, as well as the concept of suffering related to care. It is important to carry out health care procedures based on the patient needs to suffering related to care.

Magister Pharmaceuticae - Mpharm / Many studies have investigated the pharmacokinetics (PK) of anti-tuberculosis drugs in tuberculosis patients. However, currently in South Africa, no studies have been done on ethionamide (ETH) PK in adult MDR-TB patients that are infected with HIV and those without HIV infection. Therefore, the objective of this current study was firstly, to find out ethionamide plasma concentration using the LC-MS method; secondly, to evaluate and compare the pharmacokinetics of ethionamide in MDR-TB patients infected with and without HIV infection; thirdly, to examine the effects of ARVs and kidney impairment on the PK of ethionamide and fourthly, to find out the consequence of sex and age on ETH PK parameters.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A prevenÃÃo à um meio eficaz pra lidar com o HIV/Aids e a igreja como rede comunitÃria de saÃde à um cenÃrio propÃcio à construÃÃo cultural de adolescentes no que se refere à adoÃÃo de comportamentos sexuais seguros, pois adota postura cautelosa ao demonstrar valorizaÃÃo nas relaÃÃes sexuais com responsabilidade e, principalmente, com respeito a si e ao outro. O estudo apresenta como objetivo geral favorecer um espaÃo crÃtico-reflexivo voltado para o HIV/Aids, junto aos adolescentes que fazem parte de um grupo da Igreja CatÃlica no municÃpio de TianguÃ-CearÃ, com base no pensamento de Paulo Freire. Trata-se de uma pesquisa-aÃÃo, realizada no perÃodo de maio a agosto de 2009. Os sujeitos foram dez adolescentes inseridos em grupos de jovens da RenovaÃÃo CarismÃtica CatÃlica. Como instrumentos para coleta de dados utilizou-se um formulÃrio de entrevista, observaÃÃo-participante, registro fotogrÃfico, filmagens e registro em diÃrio de campo. Como mÃtodo e tÃcnica foram utilizados o CÃrculo de Cultura para articular a dimensÃo coletiva e interativa da investigaÃÃo no desenvolvimento da pesquisa-aÃÃo. Deste modo foram realizados oito CÃrculos de Cultura construÃdos de acordo com as seguintes etapas: descoberta do universo individual e coletivo, problematizaÃÃo com fundamentaÃÃo teÃrica, desconstruÃÃo de conceitos com reflexÃo teÃrica-prÃtica, (re)construÃÃo coletiva, sÃntese da vivÃncia, avaliaÃÃo de cada cÃrculo e outra avaliaÃÃo final, para estes momentos foi necessÃrio a seleÃÃo dos temas e criaÃÃo de situaÃÃes para problematizaÃÃo de acordo com a realidade percebida. Os cÃrculos consideraram os pressupostos do MÃtodo Paulo Freire, como: diÃlogo, participaÃÃo, reflexÃo teÃrico-prÃtica, valorizaÃÃo do conhecimento, respeito à cultura, acesso a conteÃdos relacionando-os à realidade e autonomia para realizaÃÃo de escolhas pautadas na reflexÃo crÃtica da realidade vivida. A anÃlise e interpretaÃÃo dos resultados privilegiaram a discussÃo dos dados, de acordo com a sequÃncia dos CÃrculos, considerando a experiÃncia vivida pelo grupo e o diÃlogo com a literatura realizada pela pesquisadora-animadora. Neste sentido os adolescentes refletiram acerca dos temas: HIV/Aids, castidade, sexualidade e prevenÃÃo no contexto religioso, momentos que permitiram a desconstruÃÃo e (re)construÃÃo de conceitos e (prÃ)conceitos. A realizaÃÃo do cÃrculo de cultura como estratÃgia educativa e investigativa com adolescentes inseridos na Igreja vem despertar a influencia que a Igreja exerce nesse grupo, quando realiza ensinamentos relacionados à castidade e fidelidade compreendidas como comportamentos a serem adotados e consequentes meios de prevenÃÃo ao HIV/Aids, o silenciamento desta a respeito da sexualidade, a desvalorizaÃÃo das informaÃÃes sobre o uso do preservativo por parte dos adolescentes e o reconhecimento da necessidade de mais conhecimento que contemplem os temas que emergiram no estudo. Assim, os enfermeiros precisam utilizar metodologias emancipatÃrias que favoreÃam o diÃlogo pautado na confianÃa e respeito entre educador/educando, fortalecendo uma relaÃÃo de amizade para a reflexÃo, envolvendo a adoÃÃo de comportamentos sexuais seguros em adolescentes inseridos na igreja. / Prevention is an effective means for working with HIV / AIDS and the church as a network of community health is a setting conducive to the cultural construction of adolescents with regard to the adoption of safe sexual behaviors, it adopts cautious to demonstrate the value of sex with responsibility and especially with respect to self and other. The study has as main objective to promote a critical and reflective area facing the HIV / AIDS with teens who are part of a group of the Catholic Church in the city of TianguÃ-CearÃ, based on the thought of Paulo Freire. This is a research- action, carried out between May and August 2009. The subjects were ten adolescents placed in youth groups of Catholic Charismatic Renewal. The instruments for data collection used a form of interview, participant observation, photographic records, filming and recording in the field diary. As the method and technique were used Circles of Culture to articulate the collective dimension of interactive research in the development of action research. Thus were carried out eight circles of culture constructed in accordance with the following steps: discovery of the Universe individual and collective problematization and theory, deconstruction of theoretical concepts and practice, collective (re) construction, summary of the experience, evaluation of each circle and one final assessment for these periods was necessary to select the themes and creating situations for questioning in accordance with the perceived reality. The circles considered the assumptions of the Paulo Freire method, such as: dialogue, participation, theoretical and practical value of knowledge, respect for culture, access to content relating to the reality and autonomy to carry out choices based on critical reflection of the reality . The analysis and interpretation of results have concentrated on the discussion of the data, according to the sequence of circles considering the experience of the group and the dialogue with the literature carried out by the researcher. In this sense the adolescents reflected on the themes: HIV / AIDS, chastity, sexuality and prevention in the religious context, moments that led to the deconstruction and (re) construction of concepts and (pre) concepts. The completion of the circle of culture as educational and investigative strategy with adolescents from the church is awakening to the influence that the church plays in this group when its teachings are related to teaching of the chastity and fidelity understood as behaviors to be adopted and the resulting means of preventing HIV / AIDS , the silencing of the church about sexuality, the devaluation of information on condom use by adolescents and recognition of the need for more knowledge that address the issues that emerged in the study. Therefore nurses need to use methodologies that promote emancipatory dialogue founded on the trust and respect between teacher / student, strengthening a relationship of friendship to the reflection about the adoption of safe sexual behaviors in adolescents in the church.