Uptake and utilization of institutional voluntary HIV testing and counseling services among students aged 18-24 in Kenya\u2019s public Universities

Background: Kenya is home to an estimated 1.7 million people living with HIV/AIDS. According to the Kenya AIDS Indicator survey KAIS 2012, HIV prevalence in the age group 15-24 stood at 2.2%. Globally, young people aged 15-24 are a highly vulnerable population with respect to HIV/AIDS infection and transmission. HIV testing and counseling services play a critical role as an entry point to care and treatment. However, uptake of HIV testing and counseling services among the youth in Kenya has been reportedly low. Youths at Universities are among the priority populations in HIV/AIDS programs. Objectives: This study aimed to determine the barriers to uptake and utilization of institution-based voluntary counseling and testing VCT services among students aged 18-24 in selected public universities in Kenya. The specific objectives were to determine the factors associated with uptake and utilization and the association between various socio-demographic factors and service uptake in institutional VCT facilities. Methods: This research utilized a descriptive cross-sectional study design where primarily, data was collected using semi-structured questionnaires and through focus group discussions held with the students in the sampled Universities. Data available at Jomo Kenyatta University of Agriculture and Technology JKUAT Hospital VCT were reviewed for the period 2010 and 2016 to give an insight into service utilization rates among students. Multi-stage sampling technique was utilized to reach a student sample size of 305 from the selected public Universities in Kenya. Results: Uptake of institutional VCT services among University students sampled stood at 45% from a population where 84.4% were aware of the presence of these services on their campuses. More males than females utilized the services. Emerging themes from the study indicated that participants utilized the services for different reasons. Accessibility to test site, testing hours, fear to be seen at site and fear of test result were also identified as factors affecting service uptake. These factors also were also reported when students were asked about their desired characteristics of a VCT facility on campus. Conclusion: This study has unraveled the factors that are associated with testing and counseling in institutional facilities. University students seem to seek and utilize VCT services for different reasons. It is also clear that patterns of services utilization vary from group to another as observed in the case of year of study, gender and age category. Recommendations: It is necessary for policy makers in institutions of higher learning together with those tasked with managing healthcare services in these institutions to adopt approaches that will overcome the barriers to utilization of VCT services among students. With knowledge of the factors associated with uptake and utilization of VCT services in institutional facilities, efforts to tackle the barriers and maximize on enhancers should be utilized fully in order to improve uptake and utilization of services. More research should also focus on the persisting risky sexual behaviors among University students despite the high knowledge they have on HIV/AIDS

Impact of gastrointestinal tract variability on oral drug absorption and pharmacokinetics : an UNGAP review

The absorption of oral drugs is frequently plagued by significant variability with potentially serious therapeutic consequences. The source of variability can be traced back to interindividual variability in physiology, differences in special populations (age- and disease-dependent), drug and formulation properties, or food-drug interactions. Clinical evidence for the impact of some of these factors on drug pharmacokinetic variability is mounting: e.g. gastric pH and emptying time, small intestinal fluid properties, differences in pediatrics and the elderly, and surgical changes in gastrointestinal anatomy. However, the link of colonic factors variability (transit time, fluid composition, microbiome), sex differences (male vs. female) and gut-related diseases (chronic constipation, anorexia and cachexia) to drug absorption variability has not been firmly established yet. At the same time, a way to decrease oral drug pharmacokinetic variability is provided by the pharmaceutical industry: clinical evidence suggests that formulation approaches employed during drug development can decrease the variability in oral exposure. This review outlines the main drivers of oral drug exposure variability and potential approaches to overcome them, while highlighting existing knowledge gaps and guiding future studies in this area

VISION-BASED TERRAIN CLASSIFICATION AND LEARNING TO IMPROVE AUTONOMOUS GROUND VEHICLE NAVIGATION IN OUTDOOR ENVIRONMENTS

Terrain is an important factor for autonomous ground vehicles (AGV), potentially ruining a mission or the platform itself. The purpose of this thesis is to develop a method for an AGV to identify and avoid hazardous terrain. This work builds on a previously developed system that uses artificial potential fields to avoid obstacles and navigate to a goal. Terrain was identified by developing a random forest machine-learning algorithm, classifying terrain as hazardous or traversable. The random forest was grown using data from images collected during this work. The classification of hazardous terrain was used to generate a repulsive force for use with artificial potential fields. The system was designed to avoid known areas of hazardous terrain using path planning, developing paths using approximate cell decomposition and the A* search algorithm. Tests of the developed random forest revealed accurate classification capabilities for all terrain types, but a tendency to misclassify certain terrain types. Portions of the navigation solution were simulated and confirmed the path planning capability. Trials conducted in a real-world environment revealed the solution stopped the AGV from entering hazardous terrain, and successfully planned routes around hazardous terrain. Improvements to the localization solution will allow the AGV to perform more consistently and over longer ranges.http://archive.org/details/visionbasedterra1094563474Captain, United States Marine CorpsApproved for public release; distribution is unlimited

Qusyr 'Amra

This red limestone palace is located on the edge of a desert oasis, approximately 50 miles east of Amman. It has been asserted that the Umayyad Caliph al-Walid built Qusayr 'Amra between 712 and 715 AD. Small in scale yet extremely well preserved, it structurally contains two main components: an audience hall and a bath. One enters the building from the north into the rectangular audience hall. Across from the main entrance stands an alcove with two little windowless rooms to either side, admitting light strictly from their entryways and reflections from the floors cemented in glass mosaics. The three rooms that make up the bath -- presumably the apodyterium, tepidarium, and caldarium, respectively -- are situated to the east of the hall's main entrance: one of which is tunnel-vaulted; another that is cross-vaulted and the third contains a dome. (Please see the plan.) To the east of the caldarium, a tunnel-vaulted passageway extends into a rectangular enclosed space that remains uncovered. Architecturally, Qusayr 'Amra's most impressive characteristic is its vaulting system, specifically in its use of pointed transverse arches. The incidence of such features demonstrates a strong eastern influence, as there are no known western examples of these arches until at least the end of the eleventh century. Source: Archnetexterior, overall vie

Qusyr 'Amra

exterior, view of of caldarium dome, 199

Umayyad Palace

exterior, entrance to the lodge, 200

Umayyad Palace

exterior, rear façade and low vaults covering the hammam, 200

Qusyr 'Amra

This red limestone palace is located on the edge of a desert oasis, approximately 50 miles east of Amman. It has been asserted that the Umayyad Caliph al-Walid built Qusayr 'Amra between 712 and 715 AD. Small in scale yet extremely well preserved, it structurally contains two main components: an audience hall and a bath. One enters the building from the north into the rectangular audience hall. Across from the main entrance stands an alcove with two little windowless rooms to either side, admitting light strictly from their entryways and reflections from the floors cemented in glass mosaics. The three rooms that make up the bath -- presumably the apodyterium, tepidarium, and caldarium, respectively -- are situated to the east of the hall's main entrance: one of which is tunnel-vaulted; another that is cross-vaulted and the third contains a dome. (Please see the plan.) To the east of the caldarium, a tunnel-vaulted passageway extends into a rectangular enclosed space that remains uncovered. Architecturally, Qusayr 'Amra's most impressive characteristic is its vaulting system, specifically in its use of pointed transverse arches. The incidence of such features demonstrates a strong eastern influence, as there are no known western examples of these arches until at least the end of the eleventh century. Source: Archnetexterior, view of audience chambers and baths, from south, 199

The impact of alcohol consumption on hospital treatment cost and length of stay for non-alcohol-related diseases : a retrospective cross sectional comparison of patients with alcohol-related co-morbidities and those without alcohol-related co-morbidities

Background: Alcohol is a commodity which contains toxic substances like ethanol and methanol (WHO, 1994). It is a primary cause of negative health effects, and a main risk factor for many other major chronic diseases (Rehm et al., 2009; WHO, 2011b). The health and economic burden attributable to alcohol is enormous thorough the globe (Rehm et al., 2009; Rutherford and McNeill, 2009). The unknown economic losses of alcohol, because of the difficulties in estimation, could be huge and misleading if not estimated with conscious (Baumberg, 2006). The intricateness and multidimensional correlations between alcohol consumption and health problems attributable to alcohol (Rehm et al., 2010) makes such estimations even more obscure. Objective: The objective of this study was to find whether there is higher treatment cost and longer length of hospital stay (LOS) for those with alcohol related co-morbidities than those without these co-morbidities, for the treatments of the pathologically non-alcohol-related diagnoses. Method: Negative binomial regression model and generalized linear regression model were applied to LOS and treatment cost respectively for 8 diagnoses selected from Norwegian patient registry 2008. Results: Patients with alcohol-related diseases had statistically significant higher treatment cost for all 8 diagnoses among males. Four diagnoses of which had longer LOS for females with alcohol-related diagnoses had also higher treatment cost amongst females. The longer LOS for erysipelas (A46), unspecified chest pain (R074), and pain localized to upper abdomen (R101) were found statistically significant for both women and men with alcohol-related diseases. In addition women with alcohol-related diagnoses had statistically significant longer LOS for unspecified asthma (J459) and acute tubule-interstitial nephritis (N10) than other women, whereas men identified as alcohol consumers were found to have longer LOS for volume depletion (E86) and other unspecified convulsion (R568) than other men. Conclusions: Alcohol related diseases co-occur with other diseases; co-morbidity of diseases is associated with increased health care costs; the result of this study implicates that patients with alcohol related diseases had higher treatment cost with longer LOS for the treatment of the non-alcohol related diagnoses. If this is the case it would mean that economic burden of alcohol is underestimated

Palace of al-Walid I

interior, columns, capitals, and corbels, and Byzantine method of alternating layers of dressed stone with bric