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Search Results: 1 - 10 of 2862 matches for " Helen Struthers "
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Promoting safe infant feeding practices – the importance of structural, social and contextual factors in Southern Africa
Ray Lazarus,Helen Struthers,Avy Violari
Journal of the International AIDS Society , 2013, DOI: 10.7448/ias.16.1.18037
Abstract: There has been significant progress towards the goal of eliminating vertical transmission of HIV by 2015. However, a question that remains is how we can most effectively prevent late postnatal transmission of HIV through infant feeding. Guidelines published by the World Health Organization in 2010 have been widely adopted. These guidelines place strong emphasis on exclusive breastfeeding, in some countries over-turning a prior emphasis on formula feeding. Where available, provision of antiretroviral treatment for HIV-positive mothers or prophylaxis for infants offers additional protection against vertical transmission through infant feeding. However, merely changing guidelines is not sufficient to change practice, particularly with regard to culturally sanctioned forms of feeding, such as mixed feeding. This commentary highlights structural, social and contextual barriers to effective implementation of the guidelines and suggests ways to address some of these barriers.
Linking the global positioning system (GPS) to a personal digital assistant (PDA) to support tuberculosis control in South Africa: a pilot study
Barry Dwolatzky, Estelle Trengove, Helen Struthers, James A McIntyre, Neil A Martinson
International Journal of Health Geographics , 2006, DOI: 10.1186/1476-072x-5-34
Abstract: The study took place in two communities in Greater Johannesburg, South Africa: Wheillers Farm, a relatively sparsely populated informal settlement, and a portion of Alexandra, an urban township with densely populated informal settlements. Ten participants in each community were asked to locate their homes on aerial photographs. Nine from Wheillers Farm and six from Alexandra were able to identify their homes. The total time taken by a research assistant, unfamiliar with the area, to locate 10 homes in each community using the given addresses was compared with the total time taken by a community volunteer with half an hour of training to locate the same homes using the device. Time taken to locate the ten households was reduced by 20% and 50% in each community respectively using the PDA/GPS device.In this pilot study we show that it is feasible to use a simple PDA/GPS device to locate the homes of patients. We found that in densely populated informal settlements, GPS technology is more accurate than aerial photos in identifying homes and more efficient than addresses provided by participants. Research assessing issues of, confidentiality and cost effectiveness would have to be undertaken before implementing PDA/GPS – based technology for this application. However, this PDA/GPS device could be used to reduce part of the burden on TB control programs."Globally there were 4.4 million new cases of tuberculosis in 2003 [1] of which a quarter were in Africa where the HIV epidemic has resulted in rapid increases in TB caseloads. HIV infection is the greatest risk factor for TB disease and current TB control strategies appear insufficient to halt the swift rise in new cases of TB consequent to HIV [2,3]. Curative therapy for TB is complex and lasts for six to eight months. Lack of knowledge of the disease, rapid subjective responses to TB treatment, travel barriers, stigma, adverse effects of medication and poor user experiences with an overburdened TB control programme (TBC
Psychosocial Environmental Barriers to School Attendance among Children with Disabilities in Two Community Based Rehabilitation in Rwanda  [PDF]
Jean Baptiste Sagahutu, Patricia Struthers
Advances in Applied Sociology (AASoci) , 2014, DOI: 10.4236/aasoci.2014.46019
Abstract:


The purpose of this study was to determine the psychosocial environmental barriers to school attendance by children with disabilities in Rwanda. A quantitative, cross-sectional, descriptive study was conducted in one urban and one rural community-based rehabilitation centre. There was a sample of 94 parents or caregivers of children with disabilities who were not attending school. A structured closed-ended questionnaire was used. The Statistical Package for the Social Sciences (SPSS) (15.0 version) was used for data analysis. The data analysis included descriptive statistics as frequency distributions and percentages. The data werepresented in the forms of cross-tables. CHI-Square was used to determine the association between variables. The level of significance (alpha) was set at 0.05. The findings indicate that in Rwanda there is a negative attitude among parents/caregivers and the community towards children with disabilities. Many parents/caregivers reported that having a child with a disability is a burden and shame in their families. A great proportion of parents/caregivers also indicated that, if they needed to make a choice, they would prioritise education for their child without the disability over their child with the disability. The majority reported the special school to be their first choice for their children with disabilities. Others reported that the community gave their children different abusive names. About the teachers’ attitude, a high proportion of parents/caregivers said that the teachers told them that their children had to go to the schools for other children with disabilities. Awareness creation and attitudinal change about disability issues are needed in Rwandese society to promote schooling for children with disabilities for the successful Education for All goals.


Statistical Assessment of Neighborhood Socioeconomic Deprivation Environment in Spatial Epidemiologic Studies  [PDF]
Min Lian, James Struthers, Ying Liu
Open Journal of Statistics (OJS) , 2016, DOI: 10.4236/ojs.2016.63039
Abstract: Neighborhood socioeconomic deprivation has been associated with health behaviors and outcomes. However, neighborhood socioeconomic status has been measured inconsistently across studies. It remains unclear whether appropriate socioeconomic indicators vary over geographic areas and geographic levels. The aim of this study is to compare the composite socioeconomic index to six socioeconomic indicators reflecting different aspects of socioeconomic environment by both geographic areas and levels. Using 2000 U.S. Census data, we performed a multivariate common factor analysis to identify significant socioeconomic resources and constructed 12 composite indexes at the county, the census tract, and the block group levels across the nation and for three states, respectively. We assessed the agreement between composite indexes and single socioeconomic variables. The component of the composite index varied across geographic areas. At a specific geographic region, the component of the composite index was similar at the levels of census tracts and block groups but different from that at the county level. The percentage of population below federal poverty line was a significant contributor to the composite index, regardless of geographic areas and levels. Compared with non-component socioeconomic indicators, component variables were more agreeable to the composite index. Based on these findings, we conclude that a composite index is better as a measure of neighborhood socioeconomic deprivation than a single indicator, and it should be constructed on an area- and unit-specific basis to accurately identify and quantify small-area socioeconomic inequalities over a specific study region.
Global Array-Based Transcriptomics from Minimal Input RNA Utilising an Optimal RNA Isolation Process Combined with SPIA cDNA Probes
Laura Kennedy,Mahesh Pauriah,Valerie Godfrey,Jacqueline Howie,Helen Dennis,Daniel Crowther,Allan Struthers,Catharine Goddard,Giora Feuerstein,Chim Lang,Gino Miele
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0017625
Abstract: Technical advances in the collection of clinical material, such as laser capture microdissection and cell sorting, provide the advantage of yielding more refined and homogenous populations of cells. However, these attractive advantages are counter balanced by the significant difficultly in obtaining adequate nucleic acid yields to allow transcriptomic analyses. Established technologies are available to carry out global transcriptomics using nanograms of input RNA, however, many clinical samples of low cell content would be expected to yield RNA within the picogram range. To fully exploit these clinical samples the challenge of isolating adequate RNA yield directly and generating sufficient microarray probes for global transcriptional profiling from this low level RNA input has been addressed in the current report. We have established an optimised RNA isolation workflow specifically designed to yield maximal RNA from minimal cell numbers. This procedure obtained RNA yield sufficient for carrying out global transcriptional profiling from vascular endothelial cell biopsies, clinical material not previously amenable to global transcriptomic approaches. In addition, by assessing the performance of two linear isothermal probe generation methods at decreasing input levels of good quality RNA we demonstrated robust detection of a class of low abundance transcripts (GPCRs) at input levels within the picogram range, a lower level of RNA input (50 pg) than previously reported for global transcriptional profiling and report the ability to interrogate the transcriptome from only 10 pg of input RNA. By exploiting an optimal RNA isolation workflow specifically for samples of low cell content, and linear isothermal RNA amplification methods for low level RNA input we were able to perform global transcriptomics on valuable and potentially informative clinically derived vascular endothelial biopsies here for the first time. These workflows provide the ability to robustly exploit ever more common clinical samples yielding extremely low cell numbers and RNA yields for global transcriptomics.
High Seroprevalence of Human Herpesviruses in HIV-Infected Individuals Attending Primary Healthcare Facilities in Rural South Africa
Erik Schaftenaar, Georges M. G. M. Verjans, Sarah Getu, James A. McIntyre, Helen E. Struthers, Albert D. M. E. Osterhaus, Remco P. H. Peters
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0099243
Abstract: Seroprevalence data of human herpesviruses (HHVs) are limited for sub-Saharan Africa. These are important to provide an indication of potential burden of HHV-related disease, in particular in human immunodeficiency virus (HIV)-infected individuals who are known to be at increased risk of these conditions in the Western world. In this cross-sectional study among 405 HIV-infected and antiretroviral therapy na?ve individuals in rural South Africa the seroprevalence of HHVs was: herpes simplex virus type 1 (HSV-1) (98%), herpes simplex virus type 2 (HSV-2) (87%), varicella zoster virus (VZV) (89%), and 100% for both Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Independent factors associated with VZV seropositivity were low educational status and having children. Lack of in-house access to drinking water was independently associated with positive HSV-1 serostatus, whereas Shangaan ethnicity was associated with HSV-2 seropositivity. Increasing age was associated with higher IgG titres to both EBV and CMV, whereas CD4 cell count was negatively associated with EBV and CMV IgG titres. Moreover, IgG titres of HSV-1 and 2, VZV and CMV, and CMV and EBV were positively correlated. The high HHV seroprevalence emphasises the importance of awareness of these viral infections in HIV-infected individuals in South Africa.
The role of urate and xanthine oxidase in vascular oxidative stress: future directions
Jacob George, Allan Struthers
Therapeutics and Clinical Risk Management , 2009, DOI: http://dx.doi.org/10.2147/TCRM.S5701
Abstract: ole of urate and xanthine oxidase in vascular oxidative stress: future directions Mini-review (4312) Total Article Views Authors: Jacob George, Allan Struthers Published Date October 2009 Volume 2009:5 Pages 799 - 803 DOI: http://dx.doi.org/10.2147/TCRM.S5701 Jacob George, Allan Struthers Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee, UK Abstract: Vascular oxidative stress has been shown to be a potent factor in the pathophysiology of endothelial dysfunction. Despite current optimal evidence-based therapy, mortality from various cardiovascular disorders remains high. The search for newer, novel ways of attenuating endothelial dysfunction has yielded several new and exciting possibilities, one of which is the manipulation of urate levels using xanthine oxidase inhibitors. Agents such as allopurinol have shown marked improvements in vascular endothelial function in various cohorts at risk of cardiovascular events. Most of the evidence so far comes from smaller mechanistic studies. The few large randomized controlled trials have failed to show any significant mortality benefit using these agents. This article highlights the potential avenues of further research such as dose-response, and the potential for these agents to regress left ventricular hypertrophy. The role of newer agents such as febuxostat and oxypurinol are discussed as well as potential reasons why some of the current newer agents have failed to live up to the promising early-phase data. It is crucial that these remaining questions surrounding urate, xanthine oxidase and the role of various agents that affect this important oxidative stress-generating system are answered, and therefore these promising agents should not be discarded prematurely.
Met and unmet palliative care needs of people living with HIV/AIDS in Rwanda
J Uwimana, P Struthers
SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) , 2007,
Abstract: The rising number of people living with HIV/AIDS (PLWHA) worldwide has made health care professionals and policy makers search for accessible health care that will meet the needs of people who are suffering from the disease and enhance their quality of life (QoL).This study investigated met and unmet palliative care needs of PLWHA in selected areas in Rwanda.The study sample included 306 participants: PLWHA, health care professionals and coordinators of HIV/AIDS units. Quantitative and qualitative methodologies were used.The data were analysed separately and then triangulated. In the findings, over 50% of PLWHA had symptoms related to HIV/AIDS most of the time, with the most common symptom being pain. Participation in activities of daily living was significantly associated with the health status of PLWHA (p<0.001).The most common perceived palliative care needs of PLWHA were medical needs, psychosocial needs and the need for financial assistance (77%); home-based care (47%); nutritional support (44%); and pain relief and management of other symptoms (43%). Most PLWHA indicated these palliative care needs were unmet, in particular the need for pain relief, symptom management, financial assistance and nutritional support. Over 50% of health care professionals reported they were not trained in palliative care.They indicated that inadequate policy and resources were the main obstacles to the provision of optimal palliative care.Addressing unmet palliative care needs would enhance the QoL of PLWHA. In addition, developing policy related to the provision of palliative care and building the capacity of health care providers is essential for the provision of adequate palliative care services in Rwanda. SAHARA J Vol. 4 (1) 2007: pp. 575-585
A conceptual investigation of process controls upon flood frequency: role of thresholds
I. Struthers,M. Sivapalan
Hydrology and Earth System Sciences (HESS) & Discussions (HESSD) , 2007,
Abstract: Traditional statistical approaches to flood frequency inherently assume homogeneity and stationarity in the flood generation process. This study illustrates the impact of heterogeneity associated with threshold non-linearities in the storage-discharge relationship associated with the rainfall-runoff process upon flood frequency behaviour. For a simplified, non-threshold (i.e. homogeneous) scenario, flood frequency can be characterised in terms of rainfall frequency, the characteristic response time of the catchment, and storm intermittency, modified by the relative strength of evaporation. The flood frequency curve is then a consistent transformation of the rainfall frequency curve, and could be readily described by traditional statistical methods. The introduction of storage thresholds, namely a field capacity storage and a catchment storage capacity, however, results in different flood frequency "regions" associated with distinctly different rainfall-runoff response behaviour and different process controls. The return period associated with the transition between these regions is directly related to the frequency of threshold exceedence. Where threshold exceedence is relatively rare, statistical extrapolation of flood frequency on the basis of short historical flood records risks ignoring this heterogeneity, and therefore significantly underestimating the magnitude of extreme flood peaks.
The role of urate and xanthine oxidase in vascular oxidative stress: future directions
Jacob George,Allan Struthers
Therapeutics and Clinical Risk Management , 2009,
Abstract: Jacob George, Allan StruthersDivision of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee, UKAbstract: Vascular oxidative stress has been shown to be a potent factor in the pathophysiology of endothelial dysfunction. Despite current optimal evidence-based therapy, mortality from various cardiovascular disorders remains high. The search for newer, novel ways of attenuating endothelial dysfunction has yielded several new and exciting possibilities, one of which is the manipulation of urate levels using xanthine oxidase inhibitors. Agents such as allopurinol have shown marked improvements in vascular endothelial function in various cohorts at risk of cardiovascular events. Most of the evidence so far comes from smaller mechanistic studies. The few large randomized controlled trials have failed to show any significant mortality benefit using these agents. This article highlights the potential avenues of further research such as dose-response, and the potential for these agents to regress left ventricular hypertrophy. The role of newer agents such as febuxostat and oxypurinol are discussed as well as potential reasons why some of the current newer agents have failed to live up to the promising early-phase data. It is crucial that these remaining questions surrounding urate, xanthine oxidase and the role of various agents that affect this important oxidative stress-generating system are answered, and therefore these promising agents should not be discarded prematurely.Keywords: urate, allopurinol, vascular oxidative stress, febuxostat
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