75 research outputs found
Establishing a cohort at high risk of HIV infection in South Africa: challenges and experiences of the CAPRISA 002 acute infection study.
No full textOBJECTIVES: To describe the baseline demographic data, clinical characteristics and HIV-incidence rates of a cohort at high risk for HIV infection in South Africa as well as the challenges experienced in establishing and maintaining the cohort. METHODOLOGY/PRINCIPLE FINDINGS: Between August 2004 and May 2005 a cohort of HIV-uninfected women was established for the CAPRISA 002 Acute Infection Study, a natural history study of HIV-1 subtype C infection. Volunteers were identified through peer-outreach. The cohort was followed monthly to determine HIV infection rates and clinical presentation of early HIV infection. Risk reduction counselling and male and female condoms were provided. After screening 775 individuals, a cohort of 245 uninfected high-risk women was established. HIV-prevalence at screening was 59.6% (95% CI: 55.9% to 62.8%) posing a challenge in accruing HIV-uninfected women. The majority of women (78.8%) were self-identified as sex-workers with a median of 2 clients per day. Most women (95%) reported more than one casual sexual partner in the previous 3 months (excluding clients) and 58.8% reported condom use in their last sexual encounter. Based on laboratory testing, 62.0% had a sexually transmitted infection at baseline. During 390 person-years of follow-up, 28 infections occurred yielding seroincidence rate of 7.2 (95% CI: 4.5 to 9.8) per 100 person-years. Despite the high mobility of this sex worker cohort retention rate after 2 years was 86.1%. High co-morbidity created challenges for ancillary care provision, both in terms of human and financial resources. CONCLUSIONS/SIGNIFICANCE: Challenges experienced were high baseline HIV-prevalence, lower than anticipated HIV-incidence and difficulties retaining participants. Despite challenges, we have successfully accrued this cohort of HIV-uninfected women with favourable retention, enabling us to study the natural history of HIV-1 during acute HIV-infection. Our experiences provide lessons for others establishing similar cohorts, which will be key for advancing the vaccine and prevention research agenda in resource-constrained settings
Team perfectionism and team performance: A prospective study
No full textPerfectionism is a personality characteristic that has been found to predict sports performance in athletes. To date, however, research has exclusively examined this relationship at an individual level (i.e., athletes’ perfectionism predicting their personal performance). The current study extends this research to team sports by examining whether, when manifested at team level, perfectionism predicts team performance. A sample of 231 competitive rowers from 36 boats completed measures of self-oriented, team-oriented, and team-prescribed perfectionism prior to competing against one another in a 4-day rowing competition. Strong within-boat similarities in the levels of team members’ team-oriented perfectionism supported the existence of collective team-oriented perfectionism at the boat level. Two-level latent growth curve modeling of day-by-day boat performance showed that team-oriented perfectionism positively predicted the position of the boat in mid-competition and the linear improvement in position. The findings suggest that imposing perfectionistic standards on team members may drive teams to greater levels of performance
Anaemia in acute HIV-1 subtype C infection.
No full textBACKGROUND: The high prevalence of anaemia and the increased morbidity and mortality associated with anaemia during AIDS has been well described yet there has been little information about anaemia and changes in haemoglobin levels during acute and early HIV-1 infection. METHODS: HIV-negative women (n = 245) were enrolled into an observational cohort as part of the Centre for the AIDS Programme of Research in South Africa (CAPRISA) Acute Infection Study. Acute infection was diagnosed following a positive HIV RNA PCR in the absence of antibodies, or detection of HIV-1 antibodies within 3 months of a previously negative antibody test. Haemotologic parameters were assessed before infection and at regular intervals in the first twelve months of HIV infection. RESULTS: Fifty-seven participants with acute HIV infection were identified at a median of 14.5 days post-infection (range 10-81) and were enrolled in the CAPRISA Acute Infection cohort at a median of 41 days post-infection (range 15-104). Mean haemoglobin prior to HIV-1 infection was 12.7 g/dL, with a mean decline of 0.46 g/dL following infection. The prevalence of anaemia increased from 25.0% prior to HIV-1 infection to 52.6% at 3 months post-infection, 61.1% at 6 months post-infection, and 51.4% at 12 months post-infection. CONCLUSIONS: Haematologic derangements and anaemia with a trend towards iron deficiency are common with acute HIV-1 subtype C infection in this small cohort. The negative impact of anaemia concurrent with established HIV infection upon morbidity and mortality has been well documented but the prognostic potential and long-term effects of anaemia during acute HIV-1 infection remain unknown
Characterisation of HIV superinfection : genetic evolution and adaptive immune responses
No full textIn this thesis we aimed to determine the timing and frequency of intra-subtype C superinfection, and to determine if the reason for superinfection was a greater genetic distance within epitopes of the superinfecting virus compared to those of circulating strains from the same cohort
Human immunodeficiency virus-specific gamma interferon enzyme-linked immunospot assay responses targeting specific regions of the proteome during primary subtype C infection are poor predictors of the course of viremia and set point.
No full textIt is unknown whether patterns of human immunodeficiency virus (HIV)-specific T-cell responses during acute infection may influence the viral set point and the course of disease. We wished to establish whether the magnitude and breadth of HIV type 1 (HIV-1)-specific T-cell responses at 3 months postinfection were correlated with the viral-load set point at 12 months and hypothesized that the magnitude and breadth of HIV-specific T-cell responses during primary infection would predict the set point. Gamma interferon (IFN-gamma) enzyme-linked immunospot (ELISPOT) assay responses across the complete proteome were measured in 47 subtype C HIV-1-infected participants at a median of 12 weeks postinfection. When corrected for amino acid length and individuals responding to each region, the order of recognition was as follows: Nef > Gag > Pol > Rev > Vpr > Env > Vpu > Vif > Tat. Nef responses were significantly (P < 0.05) dominant, targeted six epitopic regions, and were unrelated to the course of viremia. There was no significant difference in the magnitude and breadth of responses for each protein region with disease progression, although there was a trend of increased breadth (mean, four to seven pools) in rapid progressors. Correlation of the magnitude and breadth of IFN-gamma responses with the viral set point at 12 months revealed almost zero association for each protein region. Taken together, these data demonstrate that the magnitude and breadth of IFN-gamma ELISPOT assay responses at 3 months postinfection are unrelated to the course of disease in the first year of infection and are not associated with, and have low predictive power for, the viral set point at 12 months
Adaptive changes in HIV-1 subtype c proteins during early infection and their effect on disease progression
No full textFluidity of HIV-1-specific T-cell responses during acute and early subtype C HIV-1 infection and associations with early disease progression.
No full textDeciphering immune events during early stages of human immunodeficiency virus type 1 (HIV-1) infection is critical for understanding the course of disease. We characterized the hierarchy of HIV-1-specific T-cell gamma interferon (IFN-γ) enzyme-linked immunospot (ELISPOT) assay responses during acute subtype C infection in 53 individuals and associated temporal patterns of responses with disease progression in the first 12 months. There was a diverse pattern of T-cell recognition across the proteome, with the recognition of Nef being immunodominant as early as 3 weeks postinfection. Over the first 6 months, we found that there was a 23% chance of an increased response to Nef for every week postinfection (P = 0.0024), followed by a nonsignificant increase to Pol (4.6%) and Gag (3.2%). Responses to Env and regulatory proteins appeared to remain stable. Three temporal patterns of HIV-specific T-cell responses could be distinguished: persistent, lost, or new. The proportion of persistent T-cell responses was significantly lower (P = 0.0037) in individuals defined as rapid progressors than in those progressing slowly and who controlled viremia. Almost 90% of lost T-cell responses were coincidental with autologous viral epitope escape. Regression analysis between the time to fixed viral escape and lost T-cell responses (r = 0.61; P = 0.019) showed a mean delay of 14 weeks after viral escape. Collectively, T-cell epitope recognition is not a static event, and temporal patterns of IFN-γ-based responses exist. This is due partly to viral sequence variation but also to the recognition of invariant viral epitopes that leads to waves of persistent T-cell immunity, which appears to associate with slower disease progression in the first year of infection
Family planning success in two cities in Zaire
No full textBoth projects described here, Matadi and Kananga, helped health providers in those two cities offer clinical family planning services. But their approaches differed markedly. The family education program in Matadi concentrated on pioneering community-based distribution of contraceptives, with carefully supervised distributors. The Kanaga Project emphasized clinical supervision and pleasing the clients; introduced social marketing with loose supervision of retailers; and provided an information team skilled in face-to-face group meetings, plus a weekly radio program. Four factors common to both projects seemed to contribute to their success: The single-minded dedication of staff members to making family planning work. An uninterrupted supply of affordable contraceptive methods available through outlets at many locations. Enough organizational autonomy to be able to respond to problems as they arose. Such autonomy made project personnel identify more with project goals and feel responsible for achieving project objectives. Regular and supportive supervision of those responsible for service delivery. Both projects emphasized regular contact with clinic personnel - Matadi also included distributors. These contacts bolstered morale by showing that the project administration was closely following service providers'activities and by transmitting to providers the staff's enthusiam for project activities. Supervisory visits included administrative functions such as collecting service statistics and controlling inventory, but these activities were handled in a friendly, nonthreatening manner that encouraged service providers to perform their tasks well. The fourth factor is adequate funding. Both projects had special funding that allowed them to experiment with approaches for increasing contraceptive prevalence. That funding may partly explain their organizational autonomy and may have contributed to the sense of purpose and esprit de corps that developed among project staff. Larger-scale programs in Zaire have operated with significant financial constraints, so it would be unfair to compare them with these more successful projects. Special funding does not guarantee project success but may make it far more likely, conclude the authors.Health Monitoring&Evaluation,Adolescent Health,ICT Policy and Strategies,Early Child and Children's Health,Reproductive Health
UPAYA PEMERINTAH DAERAH MELALUI KEPUTUSAN BUPATI SRAGEN NOMOR : 511.1/186.1/002/2010 TERKAIT DENGAN PENANGGULANGAN KEMISKINAN DI KABUPATEN SRAGEN
No full textABSTRAK
Penelitian ini bertujuan untuk mengetahui upaya Pemerintah Daerah
Kabupaten Sragen melalui Keputusan Bupati Sragen Nomor :
511.1/186.1/002/2010 tentang Pembentukan Tim Koordinasi dan Tim Sekretariat
Koordinasi Penanggulangan Kemiskinan ( TKPK ) Kabupaten Sragen dalam
penanggulangan kemiskinan dan permasalahan yang timbul terkait dengan
penanggulangan kemiskinan serta solusi untuk mengatasi permasalahan tersebut.
Penelitian ini merupakan penelitian hukum empiris yang bersifat
deskriptif, dimana penulis berkeinginan untuk memberikan gambaran maupun
pemaparan mengenai obyek penelitian. Jenis data yang digunakan adalah data
primer dan data sekunder. Sumber data primer yang digunakan adalah wawancara
langsung dengan pihak terkait yang diteliti. Sumber data sekunder yang digunakan
adalah bahan-bahan kepustakaan, peraturan perundang-undangan, jurnal,
makalah, artikel, dan bahan dari internet serta sumber lain yang terkait. Teknik
pengumpulan data yang digunakan yaitu studi lapangan dengan langsung menuju
ke obyek penelitian dan studi kepustakaan untuk memperoleh landasan teori yang
berkaitan dengan penelitian.
Berdasarkan hasil penelitian dan pembahasan dihasilkan simpulan, yaitu
dengan adanya Keputusan Bupati Sragen Nomor: 511.1/186.1/002/2010 tentang
Pembentukan Tim Koordinasi dan Tim Sekretariat Koordinasi Penanggulangan
Kemiskinan (TKPK), kebijakan penanggulangan kemiskinan dapat berjalan
dengan baik. Karena TKPK melakukan pengendalian, pemantauan, dan tindak
lanjut dalam kegiatan penanggulangan kemiskinan. Namun demikian terdapat
permasalahan yang terjadi dari segi Pemerintahan Daerah dan dari sisi
masyarakat, yaitu: (1) TKPK hanya bersifat koordinatif, (2) terdapat banyak
ragam data kemiskinan, (3) pelayanan yang tidak efisien, (4) keterlambatan dan
keterbatasan APBD. Untuk mengatasi permasalahan tersebut, maka Pemerintah
Kabupaten Sragen membentuk lembaga baru Unit Pelayanan Terpadu
Penanggulangan Kemiskinan (UPTPK) satu pintu; mendorong partisipasi
masyarakat dan dunia usaha; dan menyediakan sarana prasarana transportasi gratis
bagi masyarakat miskin.
Kata Kunci : Pemerintah Daerah, Keputusan Bupati, Tim Koordinasi,
Penanggulangan Kemiskinan.
ABSTRACT
This research aims to determine the Sragen Local Government efforts
through Sragen Regent Decree No. 511.1/186.1/002/2010 on the Establishment of
the Coordination Team and the Office of Poverty Reduction Coordination
(TKPK) Sragen in reducing poverty and the problems that arise related to poverty
reduction and solutions to overcome these problems.
This research is a descriptive empirical laws, which the author intends to
give an overview and presentation of the research object. The type of data used
are primary data and secondary data. The primary data sources used are interviews
with relevant parties concerned. Secondary data sources used are library materials,
legislation, journals, papers, articles, and materials from the Internet and other
related sources. Data collection techniques used are field studies to directly to the
object of research and literature study to gain basic theory related to research.
Based on the findings and conclusions resulting discussion, namely the
existence of Sragen Regent Decree No. 511.1/186.1/002/2010 on the
Establishment of the Coordination Team and the Office of Poverty Reduction
Coordination (TKPK), poverty reduction policies can work well. Because TKPK
perform control, monitoring, and follow-up in the poverty reduction activities.
However, there is a problem that occurs in terms of the Local Government and of
the public, namely: (1) merely TKPK coordination, (2) there is a wide variety of
data reduction, (3) an inefficient service, (4) delays and budget limitations. To
overcome these problems, the Government established a new institution Sragen
Integrated Services Unit Poverty (UPTPK) the door; to encourage public
participation and the business; and providing transportation facilities
infrastructure for the poor.
Keywords: Local Government, Decree of the Regent, Team Coordination, Poverty
Reduction
Evolution of HIV-1 subtype C immune responses during acute and chronic HIV infection
No full textThe aim of this study was to compare the magnitude and breadth of HIV-specific T cell responses to HIV Gag and Nef mounted during acute HIV infection with those that emerged during chronic infection and to investigate the association of these responses with subsequent HIV disease progression (CD4 counts and plasma viral loads)
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