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Search Results: 1 - 10 of 329 matches for " Houben Rein MGJ "
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Monitoring the impact of decentralised chronic care services on patient travel time in rural Africa - methods and results in Northern Malawi
Houben Rein MGJ,Van Boeckel Thomas P,Mwinuka Venance,Mzumara Peter
International Journal of Health Geographics , 2012, DOI: 10.1186/1476-072x-11-49
Abstract: Background Decentralised health services form a key part of chronic care strategies in resource-limited settings by reducing the distance between patient and clinic and thereby the time and costs involved in travelling. However, few tools exist to evaluate the impact of decentralisation on patient travel time or what proportion of patients attend their nearest clinic. Here we develop methods to monitor changes in travel time, using data from the antiretroviral therapy (ART) roll-out in a rural district in North Malawi. Methods Clinic position was combined with GPS information on the home village of patients accessing ART services in Karonga District (North Malawi) between July 2005 and July 2009. Potential travel time was estimated as the travel time for an individual attending their nearest clinic, and estimated actual travel time as the time to the clinic attended. This allowed us to calculate changes in potential and actual travel time as new clinics opened and track the proportion and origin of patients not accessing their nearest clinic. Results The model showed how the opening of further ART clinics in Karonga District reduced median potential travel time from 83 to 43 minutes, and median actual travel time fell from 83 to 47 minutes. The proportion of patients not attending their nearest clinic increased from 6% when two clinics were open, to 12% with four open. Discussion Integrating GPS information with patient data shows the impact of decentralisation on travel time and clinic choice to inform policy and research questions. In our case study, travel time decreased, accompanied by an increased uptake of services. However, the model also identified an increasing proportion of ART patients did not attend their nearest clinic.
Combining Qualitative and Quantitative Evidence to Determine Factors Leading to Late Presentation for Antiretroviral Therapy in Malawi
Fiona R. Parrott,Charles Mwafulirwa,Bagrey Ngwira,Sothini Nkhwazi,Sian Floyd,Rein M. G. J. Houben,Judith R. Glynn,Amelia C. Crampin,Neil French
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0027917
Abstract: Treatment seeking delays among people living with HIV have adverse consequences for outcome. Gender differences in treatment outcomes have been observed in sub-Saharan Africa.
Changes in Mycobacterium tuberculosis Genotype Families Over 20 Years in a Population-Based Study in Northern Malawi
Judith R. Glynn,Saad Alghamdi,Kim Mallard,Ruth McNerney,Richard Ndlovu,Lumbani Munthali,Rein M. Houben,Paul E. M. Fine,Neil French,Amelia C. Crampin
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0012259
Abstract: Despite increasing interest in possible differences in virulence and transmissibility between different genotypes of M. tuberculosis, very little is known about how genotypes within a population change over decades, or about relationships to HIV infection.
Control of (Multi)Drug Resistance and Tuberculosis Incidence over 23 Years in the Context of a Well-Supported Tuberculosis Programme in Rural Malawi
Sebastian M. Mboma, Rein M. G. J. Houben, Judith R. Glynn, Lifted Sichali, Francis Drobniewski, James Mpunga, Paul E. M. Fine, Neil French, Amelia C. Crampin
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0058192
Abstract: Background The rise in tuberculosis (TB) incidence following generalized HIV epidemics can overwhelm TB control programmes in resource-limited settings, sometimes accompanied by rising rates of drug resistance. This has led to claims that DOTS-based TB control has failed in such settings. However, few studies have described the effect of a sustained and well-supported DOTS programme on TB incidence and drug resistance over a long period. We present long-term trends in incidence and drug resistance in rural Malawi. Methods Karonga District in northern Malawi has an adult HIV prevalence of ~10%. A research group, the Karonga Prevention Study, collaborates with the National Tuberculosis Programme to support core TB control activities. Bacteriological, demographic and clinical (including HIV status) information from all patients starting TB treatment in the District have been recorded since 1988. During that period isolates from each culture-positive TB patient were exported for drug sensitivity testing. Antiretroviral therapy (ART) has been widely available since 2005. Results Incidence of new smear-positive adult TB peaked at 124/100,000/year in the mid-90s, but has since fallen to 87/100,000/year. Drug sensitivity information was available for 95% (3132/3307) of all culture-positive cases. Initial resistance to isoniazid was around 6% with no evidence of an increase. Fewer than 1% of episodes involved a multi-drug resistant strain. Discussion In this setting with a generalised HIV epidemic and medium TB burden, a well-supported DOTS programme enhanced by routine culture and drug sensitivity testing may well have reduced TB incidence and maintained drug resistance at low levels.
Murine Leukemia Viruses: Objects and Organisms
Alan Rein
Advances in Virology , 2011, DOI: 10.1155/2011/403419
Abstract: Murine leukemia viruses (MLVs) are among the simplest retroviruses. Prototypical gammaretroviruses encode only the three polyproteins that will be used in the assembly of progeny virus particles. These are the Gag polyprotein, which is the structural protein of a retrovirus particle, the Pol protein, comprising the three retroviral enzymes—protease, which catalyzes the maturation of the particle, reverse transcriptase, which copies the viral RNA into DNA upon infection of a new host cell, and integrase, which inserts the DNA into the chromosomal DNA of the host cell, and the Env polyprotein, which induces the fusion of the viral membrane with that of the new host cell, initiating infection. In general, a productive MLV infection has no obvious effect upon host cells. Although gammaretroviral structure and replication follow the same broad outlines as those of other retroviruses, we point out a number of significant differences between different retroviral genera. 1. Introduction A virus can be viewed as a rather regular, relatively simple physical object. Alternatively, it can be seen as a living organism, evolving in response to selective pressures. Both views are correct! This paper will outline very briefly some of the characteristics of murine leukemia viruses (MLVs), keeping both views in mind. We will try to point out the distinctive features of these retroviruses, which are often taken as prototypes of the gammaretrovirus genus. (Retroviruses include Spumaretroviruses (also known as “foamy viruses”) and Orthoretroviruses; the latter are divided into six genera, that is, alpha-, beta-, gamma-, delta-, epsilon-, and lenti-retroviruses [1].) MLVs have been studied for many years, beginning in the 1950s, when it was realized that leukemia could be transmitted to newborn mice by a filterable agent [2–4]. They have provided many insights into the general phenomenon of leukemogenesis. The MLV genome has also been used as the starting material in the development of vectors for gene therapy. Finally, MLVs have often been viewed as “model” retroviruses. In fact, while they have been very useful in answering questions about retroviruses and their hosts, there are many ways in which gammaretroviruses differ from other retroviruses: it should never be assumed that a given property of one genus will hold for another. The best-studied retrovirus is, of course, human immunodeficiency virus (HIV-1), which is a lentivirus. One striking contrast between MLVs and HIV-1 is the relative simplicity of MLVs. As discussed below, MLVs only encode the proteins that will be
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Comparison of IDP and LJ Optimization Procedure for Establishing the Optimal Control of a Nonisothermal Fedbatch Reactor
Rein Luus
Bioautomation , 2009,
Abstract: Optimal control of a nonisothermal fedbatch reactor with heat removal constraint is used as a test problem for comparing iterative dynamic programming (IDP) and Luus- Jaakola (LJ) optimization procedure. Although there are only two control variables, the feed rate and the temperature, the heat production rate constraint makes the optimal control problem very difficult. Therefore, the problem is reformulated by using rate of heat production instead of temperature as the second control variable. To parametrize the optimal control problem, the time interval is divided into P time stages of constant length, and piecewise constant control is used at each time stage. For small values of P , both optimization procedures are almost equivalent. However, when is increased beyond 20, IDP becomes more efficient.
Practical Realism: Against Standard Scientific Realism and Anti-Realism
Rein Vihalemm
Studia Philosophica Estonica , 2012,
Abstract: In this paper, the elaboration of the concept of practical realist philosophy of science which began in the author's previous papers is continued. It is argued that practical realism is opposed to standard scientific realism, on the one hand, and antirealism, on the other. Standard scientific realism is challengeable due to its abstract character, as being isolated from practice. It is based on a metaphysical-ontological presupposition which raises the problem of the God's Eye point of view (as it was called by Hilary Putnam). Joseph Rouse's conception of science as practice, Sami Pihlstr m's pragmatic realism, and even Ilkka Niiniluoto's critical scientific realism are interpreted as practical realist conceptions. Pihlstr m suggests that the contemporary scientific realist should be prepared to accept the pragmatically naturalized Kantian transcendental perspective on realism. It is argued, however, that this realistically naturalized Kantianism can be nothing more than practical realism, as originated by Karl Marx.
Teaduslik teooria kui teadusfilosoofia kategooria
Rein Vihalemm
Studia Philosophica Estonica , 2009,
Abstract: Artiklis arendatakse alternatiivset kontseptsiooni niih sti traditsioonilisele füüsikakesksele teadusliku teooria k sitlusele kui ka seisukohale, et füüsikateooriat ei saa teadusfilosoofias m ista teadusliku teooria mudelina, sest erinevates teadustes on teooriad oma loomult erinevad. Ollakse seisukohal, et teaduslik teooria on ikkagi teadusfilosoofia kategooriana teadusliku distsipliini erip rast s ltumatu. K sitletakse p hiliselt kahte punkti: (1) miks on teadusfilosoofias p hjust kritiseerida traditsioonilist, füüsika p hjal saadud ettekujutust teaduslikust teooriast? (2) miks ei ole p hjendatud seisukoht, et nt keemias on teaduslik teooria (nt klassikaline keemilise struktuuri teooria) oma loomult füüsikateooriast (nt klassikalisest mehhaanikast) erinev? Traditsioonilise füüsikakeskse l henemisviisi puhul ei ole piisavalt uuritud, miks ieti füüsikateooria on saanud teadusliku teooria etaloniks. Teoreetilise füüsika keskne teadusekontseptsioon on olnud ühekülgselt orienteeritudmatemaatikale ja loogikale. Kui aga l htuda teooriast kui mudelite populatsioonist, nagu Ronald Giere on seda teinud ka klassikalise mehhaanika - füüsikakeskse teooriak situse traditsioonilise n ite - korral, siis osutub see teooriak situs t epoolest invariantseks teatavale tunnetustüübile, mida on alust nimetada teaduslikuks ja mis on selgesti omane ka nt keemiale.
Matthias Johann Eisen m istatuste kogumise organiseerija ja publitseerijana aastatel 1869-1890
Rein Saukas
M?etagused. Hüperajakiri , 2003,
Abstract: Matthias Johann Eisen (1857-1934), the grand old man of folklore collecting in Estonia, published five books. While compiling the first of these, named Eesti rahva m istatused [The Riddles of Estonian Folk] (1890), during the years 1887-1888, M. J. Eisen organised an interesting collection campaign, which the present article explores in more detail. By the year 1887 M. J. Eisen had come through two principally different periods in his interest in riddles - as a schoolboy he became acquainted with authentic folk repertoire that he recorded in manuscripts; and since 1876 he published his and his friends' self-made riddles in print. While collecting riddles during the period 1887-1888 (in total for 16 months), M. J. Eisen resorted to locals, as had been previously done in Estonia. In the lofty style characteristic of the contemporary time he communicated with contributors through the press by publishing two appeals and in total 16 reports on the progress of the collection campaign, where he gave the names of the contributors who had sent riddles, estimated the amount of the material, highlighted parishes where the collection work had been the most successful and encouraged people to write the riddles down . Altogether 67 contributors from 45 parishes participated in the collection campaign, and sent 5647 riddles in 78 postings. One letter contained 72 entries on average, more substantial ones had as much as 300. The riddles are written down in literary language, although a few dialect forms or words are present; for some unknown words an explanation is given. Collected manuscripts are stored in the Estonian Folklore Archives in a 495-page quarto-format volume of SKS, Eisen. Cover letters of the contributors provide valuable information about people from whom the riddles were collected, estimations to what extent riddles are still known in oral tradition (`a genre in decay'), etc. The most active contributors were schoolteachers (in total 20) and farmers (7); some have later become well-known figures in Estonian cultural history. The material sent to M. J. Eisen was relatively authentic; however, 10,6% (ca 600 texts) have been copied from printed sources or regarded later as self-made creation; this amounts to remarkably less than the total average of riddle collections (33%). On the basis of the riddles collected in 1887-1888, M. J. Eisen compiled Eesti rahva m istatused that contained 1770 riddles and 10 riddle songs. Together with the improved edition in 1913, it remained the most comprehensive publication of Estonian riddles until recently an academic pu
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