Baigiamajame darbe pateikiamas ŽIV užsikrėtusių žmonių edukacinių poreikių vertinimas ir tenkinimo svarba Lietuvoje. Darbe atskleidžiama ugdymo reikšmė ir pateikiamas ugdymo svarbos vertinimas šiuolaikinėje visuomenėje. Taip pat analizuojama užsikrėtusiųjų ŽIV diskriminacija ir lygių galimybių visuomenėje vertinimas. Darbe vertinama užsikrėtusiųjų ŽIV socialinė integracija bei dalyvavimas ugdymo procese, vertinama sergančiųjų užkrečiamomis ligomis lygių galimybių edukacinėje sistemoje didinimo svarba, pateikiamas ŽIV profesinės reabilitacijos būtinumas, atskleidžiamas ugdymo įstaigų specialistų specialiosios pagalbos teikimas sergantiesiems. Kokybinio tyrimo metodu vertinamas užsikrėtusiųjų ŽIV edukacinių poreikių ir jų tenkinimo svarbos suvokimas. Temos aktualumui pagrįsti buvo atliktas interviu su ŽIV užsikrėtusiais žmonėmis, siekiant nustatyti užsikrėtusiųjų ŽIV edukacinius poreikius. Darbo pabaigoje pateikiamos teorinės ir praktinės dalių išvados ir rekomendacijos. / This paper presents an analysis of the importance of educational needs and ability to satisfy them for people infected with HIV in Lithuania. The significance of education and it's evaluation in contemporary society is discussed; also the issues of discrimination of HIV infected and the value of equal rights are addressed. Furthermore, this paper presents the evaluation of social integration of HIV infected people and their participation in educational system, reveals the importance of increasing equal rights in education for people with infectious diseases, the necessity of professional rehabilitation of people infected with HIV and the need for specialists of educational institutions to provide special assistance. Qualitative research presented in the paper evaluates how HIV infected perceives their educational needs and the level of their fulfilment. This research is based on semi-structured interviews with people infected with HIV. At the end of the paper conclusions coming from both theoretical and empirical research parts are made and recommendations are formulated.

Carta al editor / Revisión por pares

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.

Doctor of Philosophy / Department of Diagnostic Medicine/Pathobiology / A. Sally Davis / William Wilson / Rift Valley fever virus (RVFV) is a zoonotic arbovirus that is a significant threat to livestock and humans. It is listed as #3 for most dangerous animal threats and is in the top 10 pathogens needing urgent research in preventative and control measures. Although RVFV has never been reported in the US or Europe, outbreaks outside the African continent have sparked renewed interest in developing diagnostics and vaccines to protect both agriculture and public health. Having specific and versatile diagnostics is critical for vaccine development and application. For example, diagnostic tools that aid in identifying key immunogens and understanding the virus-host interaction directly contribute to developing protective vaccines. Additionally, vaccines that are used prophylactically or in response to an outbreak require diagnostic tests to differentiate infected from vaccinated animals (DIVA). This is critical for assessing the return to ‘disease free’ status after an outbreak. Unfortunately, there are limited RVFV diagnostic tests that are versatile and DIVA compatible with the newest RVFV vaccines. We describe the development of several diagnostic tools that are DIVA compatible for detecting RVFV nucleic acid, antibodies, and antigens. First, we evaluate a fluorescence microsphere immunoassay (FMIA) for the detection of antibodies against a RVFV surface glycoprotein and the nucleocapsid protein. The targets developed in this assay provide the basis for a DIVA-compatible serological assay with a candidate RVFV Gn/Gc subunit vaccine, as well as, offer a multiplexing platform that can simultaneously screen for several ruminant diseases. Second, we describe a novel chromogenic in situ hybridization (ISH) assay to detect RVFV in formalin-fixed, paraffin-embedded (FFPE) tissues. This molecular assay offers a highly sensitive, multiplexing platform that detects RVFV RNA on the cellular level of diagnostic tissue samples. Moreover, we demonstrate the first application of ISH as a DIVA-compatible assay for candidate RVFV gene-deletion vaccines. Third, we provide working protocols for western blot (WB), immunohistochemistry (IHC), and immunofluorescence (IF) that use monoclonal or polyclonal antibodies against key RVFV antigens. These tools can be applied to pathogenesis research and used in the development of vaccine and therapeutic countermeasures against RVFV. The RVFV diagnostic methods developed and evaluated in this dissertation can serve as a model for developing diagnostic strategies for other transboundary animal diseases.

Conselho Nacional de Desenvolvimento Científico e Tecnológico / The success of control/eradication programs of bovine viral diarrhea virus (BVDV) infection necessarily includes the identification and elimination of persistently infected (PI) animals. Since these animals continuously shed virus, the prevalence and titers of antibodies in herds with PI animals are often high. Hence, bulk milk and serum samples were subjected to two serological tests in order to establish the most appropriate for herd screening. For this, 767 samples of bulk milk and 701 serum samples were analyzed by a commercial ELISA kit and by virus-neutralization test (VNT). The toxic effects of milk for cell cultures on VNT was abolished by increasing the final volume of medium during the incubation. Among the tested milk samples, 177 and 139 were positive in VNT and ELISA, respectively. Thus, the VNT showed a sensitivity (Se) of 76.8% and a specificity (Sp) of 99.5%. The Kappa index (k) was 0.82, demonstrating an excellent agreement between the two techniques. The analysis of the correlation coefficient between the absorbance values in ELISA (OD) and antibody titers in positive samples in VNT showed a moderate positivity (r = 0.57) with p<0.05. In serum samples, 442 and 602 were positive in ELISA and VNT, respectively. This resulted in a VNT sensitivity (Se) of 92.7% and specificity (Sp) of 27.1%, with (k) of 0.23, reflecting a weak agreement between the two techniques. The correlation coefficient between OD and antibody titers showed a moderate positivity (r = 0.54) with p<0.05. Testing of both milk and serum revealed a considerable number of samples with high VN titers and low ODs. On the other side, many samples with low VN titers showed high ODs in the ELISA. Based on the above mentioned results, and assuming that the presence of PI animals usually results in VN titers ≥ 80, we conclude that the VNT is more appropriate to conduct herd screening in bulk milk when the objective is to detect herds with high titers of neutralizing antibodies, potentially harboring PI animals. / O sucesso nas estratégias de controle e erradicação do vírus da diarréia viral bovina (BVDV), passa pela identificação e eliminação dos animais persistentemente infectados (PI). Como esses animais excretam continuamente o vírus, a prevalência e os títulos de anticorpos nos rebanhos que os possuem são geralmente altos. Por isso, amostras de tanques coletivos de leite são frequentemente utilizadas na triagem de rebanhos. No presente trabalho, amostras coletivas de leite e amostras de soro foram submetidas a duas técnicas sorológicas, a fim de estabelecer a mais adequada para esta finalidade. Para tal, 767 amostras coletivas de leite e 701 amostras de soro bovino foram testadas com um kit ELISA indireto (teste padrão) e pela técnica de vírus-neutralização (VNT). Devido aos efeitos tóxicos do leite sobre o cultivo celular, a VNT foi adaptada, o que consistiu no aumento do volume final na etapa de incubação com os cultivos celulares. No teste do leite, foram positivas 177 e 139 amostras, no ELISA e na VNT, respectivamente. Com isso, a VNT adaptada apresentou uma sensibilidade (Se) de 76,8% e uma especificidade (Sp) de 99,5%. O índice Kappa (k) foi de 0,82, demonstrando uma ótima concordância entre as duas técnicas. A análise do coeficiente de correlação entre os valores de absorbância no ELISA (OD) e os títulos de anticorpos na VNT nas amostras positivas, demonstrou uma correlação moderada positiva (r = 0,57) com p<0,05. No teste do soro, foram positivas 442 e 602 amostras no ELISA (teste padrão) e na VNT, respectivamente. Observou-se uma (Se) de 92,7% e (Sp) de 27,1%, com (k) de 0,23, demonstrando uma fraca concordância entre as duas técnicas. O coeficiente de correlação entre OD e os títulos de anticorpos demonstrou uma correlação moderada positiva (r = 0,54) com p<0,05. Observaram-se nos testes do leite e do soro, várias amostras com títulos altos na VNT apresentando ODs baixas a medianas. Por outro lado, várias amostras com títulos neutralizantes baixos apresentaram ODs altas. Baseado nos resultados, e partindo do pressuposto que a presença de animais PI reflete-se em títulos neutralizantes geralmente ≥ 80, conclui-se que a VNT é mais adequada para a realização de triagem em amostras coletivas de leite quando objetiva-se detectar rebanhos com altos títulos de anticorpos neutralizantes, possíveis portadores de animais PI.

This research focuses on the lives of migrant mine labourers in the Free State Gold mines of Welkom. After a lengthy absence from home, away from home, some of the migrant mine labourers contact the deadly disease of HIV/AIDS. As they become weaker to work at the mines, some are relegated work at the surface, some are sent to the local hospice whilst some are left to die alone without anyone caring for them. The local community of Welkom regarded these miners as the carriers and transporters of this deadly disease due to their perceived slackness in morality by using the services of the local ladies of the night (commercial sex workers). On the basis of the above painted scenario, the migrant mine labourers were thus subjected to discrimination and stigmatisation by the local community, who regarded them as foreigners even in their country of birth. The research, therefore, aimed to pastorally journey with the infected mine labourers through their trauma of being infected by HIV/AIDS AND of being discriminated and rejected by the community which is supposed to support them in their hour of need and despair. Since the spread of HIV/AIDS is largely through sexual contact, the research, therefore, examined both the community and the church’s attitude towards sex, stigma and discrimination. A participatory observation approach was used and the analysis of the concepts that were at play during the trauma of the infected mine labourers were examined. In this research, the local community was viewed as the fertile ground of hostility against the infected migrant mine labourers. In this regard, the study powered the infected mining community with the challenges posed by HIV/AIDS and therefore sought ways and means of forming a support base for those infected and affected. This was done by breaking the conspiracy of silence around the issue of HIV/AIDS both at the community and the church level. Finally, the study concluded with ways of empowering the pastoral care-giver on how to journey with someone who has been diagnosed with HIV in order to close one’s last chapter of life in honour and dignity. New approaches based on relevant literature and affirmation of God’s power and healing were suggested. / Dissertation (MA(Theol))--University of Pretoria, 2011. / Practical Theology / unrestricted

This research covers the story of four persons from different backgrounds brought together by their faith in God, fellowship in the same church, residing in the same community and sharing the experience of living with HIV and AIDS: either as infected and/or affected individually. I am one of these persons due to the fact that I lost my sister to HIV and AIDS, thus I am affected. Though I only appear in the story as the researcher, it is my own loss that made it possible for me to empathise with my co-researchers. While one co-researcher was affected due to the fact that her husband was infected, became ill and died of HIV and AIDS-related sicknesses, the other two women were both infected by their husbands and at the same time were affected because they had to nurse the same husband who infected them. This was one of the cruelest moments in their lives but they forgave their husbands and cared for them to the end. In order for my research to reach the holistic insight into these women’s stories, I used the postfoundationalist practical theology approach. The reason for this is that this approach is contextual and relevant to people’s everyday life. One does not have to import knowledge to try to solve problems emanating from a particular context, but one needs to engage the locals and from that engagement, people start to reflect positively on their problems. Other lessons learnt is that one needs more than just a religious experience to play a role in solving the problem of HIV and AIDS; one needs more of the other disciplines to work together. In places like Mozambique, HIV and AIDS is not regarded as one of the health problems, but is classified as an interdepartmental or multi-sectoral problem. This means that HIV and AIDS do not affect only the Health Department, but all the departments. As such, each department is expected to have its own HIV and AIDS budget. It is here that I propose the Multi Disciplinary Team (MDT) composed of professionals from different disciplines working together to help solve the problem at hand. HIV and AIDS also help us to revisit our own understanding of God. While some people see the pandemic as the punishment from God for promiscuity, the truth is that we are all created in His image and this loving God does not destroy His own creation through HIV and AIDS. In His loving care, He reaches out to the unreached and cares for all His people: whether they are infected with HIV and AIDS, cancer or just are as healthy as they could be. The process of this research has empowered and enabled me to contribute to those who are infected and affected to be resilient and to stand, having hope in the goodness of God, working with others to bring a lasting solution to those infected and affected. Being resilient helps one to reclaim the marred Image of God in oneself and to reflect that image to impact onto our communities. / Thesis (PhD)--University of Pretoria, 2011. / Practical Theology / unrestricted

This study examined strategies that can be used for bringing about HIV/AIDS awareness in primary schools. The strategies are effective teaching skills that can be employed by educators for bringing HIV/AIDS awareness to primary school learners. The responsibilities of educators in the implementation of HIV/AIDS programs in primary schools were discussed. It was noted that educators have a great responsibility of teaching learners about HIV/AIDS, the most important of which was to provide learners with accurate information regarding HIV/AIDS. Another one was that educators should also make sure that effective teaching and learning of HIV/AIDS does takes place in the schools. The study has also examined knowledge that children should have regarding the HIV/AIDS epidemic. The basic awareness of HIV/AIDS by children was found to be essential. Some of the factors that promote the spread of HIV infection were also discussed. Different types of STIs were discussed. From the discussions, it is evident that there is a link between STIs and HIV/AIDS. Although STIs can be treated by medication, they are sometimes hard to cure. In this study, it was discovered that the early and correct treatment of STIs is an important weapon in the armoury against HIV transmission. The significance of life skills programs in primary schools was also examined. It was discovered that the subject of HIV/AIDS could not be taught in isolation; life skills programs should always be included. The issue of primary school learners who are infected and affected by HIV/AIDS was also discussed. It was discovered that in the context of HIV/AIDS, learners fall into two main groups, namely the infected and affected. Infected learners are those learners who are living with the virus in their bodies, while affected learners are those who have infected family members or friends. Various ways by which HIV can be transmitted and prevented in primary schools were also examined. Strategies that can be used for bringing about HIV/AIDS awareness in primary schools were dealt with in chapter six. Recommendations based on teaching skills that can be used by educators in presenting HIV/AIDS lessons were made. / Dissertation (Magister Educationis (Learners Support, Guidance and Counselling))--University of Pretoria, 2006. / Educational Psychology / unrestricted

This thesis has been an attempt to observe the role antibodies play in extending the life span of tumor infected Akr mice.

MPH / Department of Public Health / HIV/AIDS is an overwhelming global pandemic that affects the country’s health-care system. In order to reduce HIV/AIDS morbidity and mortality, the World Health Organization has called on countries to provide earlier access to antiretroviral therapy. In order to comply with the World Health Organization’s call, South Africa has developed the National Consolidated Guidelines, which were aimed at increasing access to ART as well as reducing new infections through viral suppression. Although the new guidelines have been implemented, they have not been fully implemented, especially in rural-based Primary Health Care facilities. The researcher observed that women who were pregnant were not tested every three months, as prescribed by the HIV/AIDS guidelines. The aim of this study was to investigate Challenges faced by health professionals regarding the implementation of HIV/AIDS guidelines at PHC facilities of Vhembe District, South Africa. This study adopted a qualitative, explorative, descriptive and contextual approach targeting nurses working at rural-based primary health care facilities at Vhembe District. Face-to face in-depth, Semistructured interviews were conducted, audiotaped and transcribed verbatim. The study used non-probability quota sampling method to identify participants until data saturation was reached with 12 participants. The results revealed that nurses faced some challenges when implementing HIV/AIDS guidelines, including shortages of resources, poor technical support, poor infrastructure, work overload, patients starting ART while there are not ready, shortage of ART, late booking of antenatal care, and mothers’ denial of HIV positive status, HIV positive babies, and poor RPC after birth. Ethical considerations were observed throughout the study. The data collected was analyzed using interpretative phenomenological analysis and all measures to ensure trustworthiness of the study findings were ensured. Some recommendations were made based on the findings of the study / NRF