A quantitative, descriptive, explorative survey was conducted to explore and describe nurses’ perceptions of disclosure to children of their HIV positive status in Addis Ababa. 100 nurses working in six conveniently sampled health centres participated by completing a self-administered questionnaire. The findings revealed that the majority of participants were of the opinion that children have the right to know their HIV status, participate in their own treatment, and that disclosure contributes towards improved adherence. Forty-one of the participants said that it is nurses’ role to support caregivers in the disclosure process. But 56.3% felt they lacked the training to disclose to children that they are infected with HIV. Accordingly, it is recommended that relevant and applied training is required to equip nurses with the knowledge and skills to disclose to children their status. The importance of nurses’ proactive role in disclosure to children of their HIV status needs to be emphasised. / Health Studies / M.A. (Public Health)

This thesis firstly presents a nonlinear extended deterministic Susceptible-Infected (SI) model for assessing the impact of public health education campaign on curtailing the spread of the HIV pandemic in a population. Rigorous qualitative analysis of the model reveals that, in contrast to the model without education, the full model with education exhibits the phenomenon of backward bifurcation (BB), where a stable disease-free equilibrium coexists with a stable endemic equilibrium when a certain threshold quantity, known as the effective reproduction number (Reff ), is less than unity. Furthermore, an explicit threshold value is derived above which such an education campaign could lead to detrimental outcome (increase disease burden), and below which it would have positive population-level impact (reduce disease burden in the community). It is shown that the BB phenomenon is caused by imperfect efficacy of the public health education program. The model is used to assess the potential impact of some targeted public health education campaigns using data from numerous countries. The second problem considered is a Susceptible-Infected-Removed (SIR) model with two types of nonlinear treatment rates: (i) piecewise linear treatment rate with saturation effect, (ii) piecewise constant treatment rate with a jump (Heaviside function). For Case (i), we construct travelling front solutions whose profiles are heteroclinic orbits which connect either the disease-free state to an infected state or two endemic states with each other. For Case (ii), it is shown that the profile has the following properties: the number of susceptible individuals is monotone increasing and the number of infectives approaches zero, while their product converges to a constant. Numerical simulations are shown which confirm these analytical results. Abnormal behavior like travelling waves with non-monotone profile or oscillations are observed.

Made available in DSpace on 2014-06-11T19:32:52Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-02-12Bitstream added on 2014-06-13T19:03:33Z : No. of bitstreams: 1 dias_fc_dr_jabo.pdf: 950154 bytes, checksum: 170fddcca2fc4c7004161e93f093a97f (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / A ocorrência de anticorpos neutralizantes contra os genótipos do vírus da diarréia viral bovina (BVDV 1 e BVDV 2) foi verificada, pelo teste de virusneutralização (VN), em 260 amostras de soro sangüíneo de 26 rebanhos não vacinados contra o BVDV, provenientes dos Estados de Minas Gerais e São Paulo. Do total de amostras, 102 (39,2%) reagiram ao BVDV, das quais 81 (31,1 %) foram reagentes ao BVDV 1 e ao BVDV 2, sete (2,7%) reagiram apenas ao BVDV 1 e 14 (5,4%) reagiram apenas ao BVDV 2. Nos mesmos rebanhos, verificou-se também a presença sugestiva de animais persistentemente infectados (PI) por meio da pesquisa de anticorpos neutralizantes em cinco amostras de soro sangüíneo de bezerros sentinelas com idade entre 6 e 12 meses. A ocorrência de animais PI foi pesquisada em três dos 26 rebanhos, dos quais foram colhidas amostras pareadas de sangue de todos os animais do rebanho. Todas as amostras foram submetidas ao teste de VN contra o BVDV 1 e o BVDV 2, e naquelas não reagentes a pelo menos um dos genótipos, bem como nas amostras provenientes de bovinos com menos de seis meses de idade, foi realizada a pesquisa do vírus pela RT-PCR. Em um dos rebanhos foram detectados dois animais PI, cujas estirpes foram caracterizadas geneticamente como pertencentes ao subgenótipo eVOV 1 b. A infecção natural pelo BVDV foi monitorada nos três rebanhos selecionados para a pesquisa de animais PI, sendo que em dois deles constatou-se a eliminação do BVDV. No entanto, a infecção permaneceu no rebanho em que haviam sido detectados dois animais PI, pois foram diagnosticados posteriormente um animal transitoriamente infectado (TI) e novos animais reagentes ao vírus. Foram submetidos à análise estatística os resultados dos testes de VN contra o BVDV 1 e o BVDV 2, realizados em 1925 amostras de soro sangüíneo obtidas no período de execução... / The occurrence of neutralizing antibodies against to bovine viral diarrhoea virus genotypes (BVDV 1 and BVDV 2) has been confirmed by virusneutralization test (VN) in 260 samples of blood serum undertaken in the states of Minas Gerais and São Paulo, Brazil. Samples were retrieved from 26 cattle herds which were not BVDV vaccinated. One hundred and two samples (39.2%) were reagents to BVDV, or rather, 81 (31.1%) were reagents to BVDV 1 and BVDV 2, seven (2.7%) were reagents to BVDV 1 only and 14 (5.4%) were reagents to BVDV 2 only. In the same herds, the significant presence of persistently infected (PI) animais was also verified by a research involving neutralizing antibodies in five samples of blood serum in 6 to 12¬month-old calves. The occurrence of PI animais was researched in three out of 26 herds by paired blood samples of total animais in the herdo Ali samples were analyzed by VN test against to BVDV 1 and BVDV 2, and virus research was undertaken by RT-PCR in samples which were not reagent to at least one of the genotypes and in samples of less than 6-month-old cattle. Two PI animais, genetically characterized as belonging to BVDV 1 b subgenotype, were detected in one of the herds. BVDV natural infection was monitored in three herds selected for PI animais research. BVDV was eliminated in two herds. However, infection remained in the herd in which two PI animais were diagnosed, because a transiently infected animal (TI) and other virus-reagent animais were detected later on. Statistical analysis evaluated VN test results against BVDV 1 and BVDV 2 with 1925 samples of blood serum obtained during the research period. Although no significant ditterences were found between BVDV 1 reagent bovines and BVDV 2 reagent ones (p>0.05), a significant ditterence was detected among titles of antibodies from samples which were reagent to both genotypes (p<0.0001).

Orientador: Samir Issa Samara / Banca: Claudia Del Fava / Banca: Amauri Alcindo Alfieri / Banca: Adolorata Aparecida Bianco Carvalho / Banca: Aramis Augusto Pinto / Resumo: A ocorrência de anticorpos neutralizantes contra os genótipos do vírus da diarréia viral bovina (BVDV 1 e BVDV 2) foi verificada, pelo teste de virusneutralização (VN), em 260 amostras de soro sangüíneo de 26 rebanhos não vacinados contra o BVDV, provenientes dos Estados de Minas Gerais e São Paulo. Do total de amostras, 102 (39,2%) reagiram ao BVDV, das quais 81 (31,1 %) foram reagentes ao BVDV 1 e ao BVDV 2, sete (2,7%) reagiram apenas ao BVDV 1 e 14 (5,4%) reagiram apenas ao BVDV 2. Nos mesmos rebanhos, verificou-se também a presença sugestiva de animais persistentemente infectados (PI) por meio da pesquisa de anticorpos neutralizantes em cinco amostras de soro sangüíneo de bezerros sentinelas com idade entre 6 e 12 meses. A ocorrência de animais PI foi pesquisada em três dos 26 rebanhos, dos quais foram colhidas amostras pareadas de sangue de todos os animais do rebanho. Todas as amostras foram submetidas ao teste de VN contra o BVDV 1 e o BVDV 2, e naquelas não reagentes a pelo menos um dos genótipos, bem como nas amostras provenientes de bovinos com menos de seis meses de idade, foi realizada a pesquisa do vírus pela RT-PCR. Em um dos rebanhos foram detectados dois animais PI, cujas estirpes foram caracterizadas geneticamente como pertencentes ao subgenótipo eVOV 1 b. A infecção natural pelo BVDV foi monitorada nos três rebanhos selecionados para a pesquisa de animais PI, sendo que em dois deles constatou-se a eliminação do BVDV. No entanto, a infecção permaneceu no rebanho em que haviam sido detectados dois animais PI, pois foram diagnosticados posteriormente um animal transitoriamente infectado (TI) e novos animais reagentes ao vírus. Foram submetidos à análise estatística os resultados dos testes de VN contra o BVDV 1 e o BVDV 2, realizados em 1925 amostras de soro sangüíneo obtidas no período de execução... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The occurrence of neutralizing antibodies against to bovine viral diarrhoea virus genotypes (BVDV 1 and BVDV 2) has been confirmed by virusneutralization test (VN) in 260 samples of blood serum undertaken in the states of Minas Gerais and São Paulo, Brazil. Samples were retrieved from 26 cattle herds which were not BVDV vaccinated. One hundred and two samples (39.2%) were reagents to BVDV, or rather, 81 (31.1%) were reagents to BVDV 1 and BVDV 2, seven (2.7%) were reagents to BVDV 1 only and 14 (5.4%) were reagents to BVDV 2 only. In the same herds, the significant presence of persistently infected (PI) animais was also verified by a research involving neutralizing antibodies in five samples of blood serum in 6 to 12¬month-old calves. The occurrence of PI animais was researched in three out of 26 herds by paired blood samples of total animais in the herdo Ali samples were analyzed by VN test against to BVDV 1 and BVDV 2, and virus research was undertaken by RT-PCR in samples which were not reagent to at least one of the genotypes and in samples of less than 6-month-old cattle. Two PI animais, genetically characterized as belonging to BVDV 1 b subgenotype, were detected in one of the herds. BVDV natural infection was monitored in three herds selected for PI animais research. BVDV was eliminated in two herds. However, infection remained in the herd in which two PI animais were diagnosed, because a transiently infected animal (TI) and other virus-reagent animais were detected later on. Statistical analysis evaluated VN test results against BVDV 1 and BVDV 2 with 1925 samples of blood serum obtained during the research period. Although no significant ditterences were found between BVDV 1 reagent bovines and BVDV 2 reagent ones (p>0.05), a significant ditterence was detected among titles of antibodies from samples which were reagent to both genotypes (p<0.0001). / Doutor

Wound infection is a major clinical burden that can significantly impede the healing process and cause severe pain. Prolonged wound infection can lead to long-term hospitalization or death. Pre-clinical research to evaluate new drugs or treatment strategies relies on animal studies. However, animal studies have several challenges including interspecies variations, cost, and, ethics question the success of these models. Recent advances in tissue engineering have enabled the development of in vitro human skin models for wound infection modeling and drug testing. The existing skin models are mostly representative of the healthy human skin and its normal functions. However, to study the wound healing process and the response of skin to the infection, there is still a need to develop a skin model mimicking the wound infection. This work presents a simplified functional infected epidermis model, fabricated with enzymatically crosslinked gelatin hydrogel. The immortalized human keratinocytes, HaCaT cells, was successfully cultured and differentiated to a multilayer epidermis structure at the air-liquid interface, and expressed terminal differentiation marker, filaggrin, in the outer layer. The barrier function of the epidermis model was studied by measuring the electrical resistance and tissue permeability across the layer. The results showed that the developed epidermis model offered a higher electrical resistance and a lower drug permeability compared to the cell monolayer on gelatin and cell-free gelatin. To show the capability of the developed epidermis model in wound modeling and drug, the model was infected with Escherichia coli and the inflammatory response of keratinocytes was studied by measuring the level of proinflammatory cytokines, including IL-1β and TNF-α. The results demonstrated the proinflammatory response of the epidermis model to infection by producing a higher level of TNF-α and IL-1β compared to the control group. While treating with antibiotic ciprofloxacin terminated the proinflammatory response and reduced the level of TNF-α and IL-1β. The robust fabrication procedure and functionality of this model suggest that this model has great potential for wound modeling and high throughput drug testing. / Graduate

Two experiments were conducted at the University of Kentucky, Eden Shale Farm, Owenton, KY to evaluate the use of MTB-100TM (Alltech, Inc., Nicholasville, KY) to alleviate the symptoms of fescue toxicity when lactating Angus x Beefmaster cows and their calves grazed endophyte-infected KY-31 tall fescue. Experiment 1 provided a carbohydrate based toxin adsorbent, MTB-100TM, ad libitum in a commercial mineral supplement to project a daily consumption rate of 0, 20 or 40 g of MTB-100TM per cow. Cows were weighed, assigned a body condition score (BCS) and hair coat score (HC), rectal temperatures were recorded and fecal grab samples were taken for ergovaline (EV) and lysergic acid (LA) analysis every 35 days for three grazing seasons (May to September). Calves were also weighed and assigned a HC score. Although MTB-100TM did not improve cow or calf performance, cows older than 4 years and those with greater Beefmaster breeding exhibited a higher tolerance to fescue toxicity than 2 and 3-yr-olds and cows with greater Angus breeding. Experiment 2 was conducted to evaluate the response of lactating beef cows and their calves to strategic supplementation with MTB-100TM. MTB-100TM was mixed with a complete mineral so daily intake was projected to be 0 or 20 g/cow. The experimental period extended from May 5 to October 2 and was divided into 3 strategic periods: P1 = May 5 to July 5; P2 = July 5 to August 31; P3 = August 31 to October 2. Treatments were either 0 or 20 g•cow-1•d-1 MTB-100TM within a period (Treatment 1 = 0, 0, 0; Treatment 2 = 20, 0, 20; Treatment 3 = 0, 20, 0; Treatment 4 = 20, 20, 0; and Treatment 5 = 20, 20, 20). Cow and calf performance was measured the same as Exp. 1, but every 21 days. Supplementation early in the grazing season tended to improve cow weight gain and body condition; however, there was no effect on calf performance. Fecal output of EV and LA did not increase in either experiment with supplementation. In conclusion, strategically invoked MTB-100TM consumption can increase performance of cows grazing endophyte-infected tall fescue forage.

Thesis advisor: Kevin J. Mahoney / Recent empirical epidemiological and behavioral research has indicated that some secondary intervention preventions (e.g., condom use, HIV-disclosure, serosorting, etc.) might not be suitable for all HIV-infected gay and bisexual men, particularly for those who engage in multiple episodes of unprotected anal intercourse (UAI). The purpose of this dissertation was to answer the primary research question: What are the psychological, behavioral and contextual factors associated with HIV-infected men who have sex with men (MSM) who engage in risky sexual behavior? A qualitative descriptive approach was used to conduct a content analysis of 14 in-depth, semi-structured interviews and to provide a description of the lives of MSM who do not consistently use traditional secondary risk behavior strategies (e.g., safer-sex negotiation, condom use, etc.) to reduce HIV transmission among sexual partners, particularly those partners who are HIV-uninfected or whose HIV status is unknown. Risky sexual behavior was defined by HIV-infected MSM who had engaged in multiple episodes of UAI in the past three months. These interviews gathered preliminary data on the feasibility and acceptability of secondary HIV behavioral prevention strategies for MSM who engage in very risky sexual behavior. In addition, these data have identified descriptive themes that could be used to augment traditional secondary HIV invention preventions, creating new and specific risk-reduction strategies for this very high-risk group. / Thesis (PhD) — Boston College, 2011. / Submitted to: Boston College. Graduate School of Social Work. / Discipline: Social Work.

O estudo visa investigar à utilização da atividade grupal em enfermagem como alternativa terapêutica no atendimento ambulatorial de portadores de HIV/aids. Com a finalidade de melhorar a adesão do paciente ao tratamento, os objetivos deste estudo foram: analisar o processo grupal como recurso terapêutico e de ajuda no tratamento clínico-ambulatorial; colocar frente a frente pacientes portadores de HIV/aids nas diferentes etapas da doença; propiciar trocas de experiências e diminuição de angústias; identificar através de depoimentos dos portadores e equipe envolvida na atividade grupal, as vantagens e desvantagens deste tipo de abordagem, para a melhoria da qualidade de vida do portador do HIV/aids. A partir de uma abordagem qualitativa, referenciando-se a história oral temática, utilizou-se o trabalho em grupo para abordar 13 usuários do Ambulatório Escola – Faculdade de Enfermagem de Passos – UEMG, todos portadores do HIV/aids, com idades oscilando entre 25 a 55 anos. Os funcionários do Ambulatório Escola representados por 04 enfermeiros, 01 psicóloga, 01 dentista, 01 auxiliar/acadêmico de enfermagem, 06 acadêmicos de enfermagem e 01 funcionário do setor de serviços gerais fizeram parte de avaliação do estudo (entrevista). Os resultados revelaram que, antes de freqüentarem o dispositivo grupal, os pacientes permaneciam sem atividades, afastados dos amigos, familiares e da equipe que os assistia. A modalidade de grupo propicia mudanças de comportamento dos sujeitos consideradas benéficas para sua aceitação e adesão ao tratamento, favorece uma maior e melhor convivência entre pacientes e equipe e que sentimentos negativos advindos da doença, são aliviados pelo suporte emocional oferecido pelo grupo. Conclui-se, com o trabalho, que as atividades grupais devam ser utilizadas pelos enfermeiros como recurso terapêutico no tratamento dos portadores de HIV/aids, possibilitando um espaço valioso para troca de experiências e compreensão dos aspectos psicossociais do ser humano. Conclui-se, pela necessidade de adequação a formação do enfermeiro e apoio específico para a equipe que desenvolve projetos desta natureza. / The study aims the utilization of group approach in nursing like therapeutics alternative in health-place attending of infected people with HIV virus. In order to improve the support of the patient in treatment, the objectives in this study were: to analyze the group process like therapeutics resource and the help in clinical-health-place treatment, to put face to face infected people with HIV virus in different stages of illness; to give conditions to exchange of experiences and fall of anguishes, to identify through statements of infected people with HIV virus and staff involved in group activity, the advantages and disadvantages in this kind of approach, for the improvement of life quality of infected people with HIV virus. From the qualified approach, used the work in group to approach 13 users of Health-place school – Nursing College in Passos – UEMG, all infected people with HIV virus, with age varying between 25 and 55 years old. The employees of Health-place School represented by 04 nurses, 01 psychologist, 01 dentist, 01 academic-nursing assistant, 06 nursing academic and 01 employee of general service sector were part of assessment of the study (interview). The results show that, before this study, the patients remained without activities, they moved away the friends, relatives, and the group that watches them. The modality of the group facilitates changes on behavior of the subjects considered beneficial for their acceptation and support on treatment, favor some bigger and better acquaintance between patients and group and that negative feelings happened by the illness, are relieved by emotional support offered by the group. It concluded, with the work, that the group activities must be used by nurses like therapeutics resource in treatment of infected people with HIV virus, allowing some valuable space to change the experiences and comprehension of psychosocial aspects of human being. It concluded, by need of adjustment the formation of nurse and specific base by the group that develops projects of this nature.

The purpose of this study was to examine general life stressors and emotion-focused and problem-focused coping strategies as prospective predictors of psychological distress in a sample of 209, low-income, urban, HIV-positive, African-American women. A secondary aim was to determine whether coping strategies mediated the relationship between life stressors and psychological distress. This study involved a secondary data analysis from a longitudinal National Institutes of Health (NIH) funded, randomized, family therapy efficacy study (Structural Ecosystems Therapy [SET]; Szapocznik et al., 2004). Participants completed self-report measures, including the Brief Symptom Inventory, Brief Cope (adapted), and Difficult Life Circumstances, as measures of psychological distress, problem-focused and emotion-focused coping, and general life stressors, respectively. These measures were completed at baseline, and at 3, 6, 9, and 18-month follow-up assessments. Results from longitudinal, cross-lagged, path model analyses provided some modest support regarding the hypothesis relating amount of life stressors to subsequent level of psychological distress symptoms. Results of the coping path models failed to support the hypotheses relating problem-focused coping and emotion-focused coping to subsequent distress (Hypotheses 2 and 3). Furthermore, the lack of direct associations between coping strategies and distress prohibited the examination of problem-focused and emotion-focused coping strategies as possible mediators in the relationship between life stressors and psychological distress. Results and implications are discussed.

Human immune deficiency virus (HIV) and Acquire immune deficiency syndrome (AIDS) is a worldwide epidemic that impacts individuals physically, socially, and psychologically, and the rates of HIV/AIDS in youth are rising. Antiretroviral treatments have drastically prolonged life in individuals with HIV/AIDS; however, this type of treatment requires strict medication adherence. Many psychosocial factors impacting antiretroviral adherence have been explored, yet very little has been investigated regarding body image. This study investigated the potential impact of body dissatisfaction on antiretroviral medication adherence in adolescents with HIV. Seventy five male and female youth were administered questionnaires on the constructs of body dissatisfaction and medication adherence. Results support the hypothesis that body dissatisfaction negatively impacts medication adherence; yet, its effect in this sample was small (R2 = .06; F(1,61) =3.87, p =.05). Additionally, it was predicted that gender would moderate the nature of the relation between body dissatisfaction and medication adherence, given the disparate societal presentations of ideal body types among genders. However, within the current sample, gender did not have an effect on this relation. Furthermore, this study was interested in exploring if body dissatisfaction within a population of HIV-infected youth was best explained by specific body dissatisfaction with areas of the body associated with lipodystrophy or lipoatrophy syndromes. Due to a very small presentation of these syndromes in the final sample (n = 4), it was not surprising that body dissatisfaction was not best explained through specific dissatisfaction with these body parts. However, dissatisfaction with muscularity in general, was predictive of general body dissatisfaction regardless of gender. A discussion of these findings is included. This study is one of the first of its kind to explore the potential detrimental effects of body dissatisfaction in HIV infected youth.