491 research outputs found

    Antiretroviral Therapy outcomes among adolescents and youth in rural Zimbabwe

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    Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10-30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10-15 (young adolescents) 15.1-19 years (adolescents), 19.1-24 years (young adults) and 24.1-29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17-4.35). Young adults and adolescents had a 2-3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62-4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults

    Developing a Theoretical Framework for Response: Creative Writing as Response in the Year 6 Primary Classroom

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    Focusing on the creative writing of Year 6 boys as they make the transition to Year 7, this article establishes a theoretical model for creative writing as response. In line with Bakhtin’s notion of utterances as ‘interpersonal’ (1986), the model demonstrates the complexity of creative writing – the text is influencing of and influenced by an author’s participation in ‘figured worlds’ (Holland, Lachicotte, Skinner and Cain 1998), but also influencing of and influenced by future respondents. This article suggests that ‘weaker framing’ (Bernstein 2000) in creative writing pedagogy has the potential to alter boys’ identities and refigure their worlds

    12-An Archaeological Survey of the Thornapple River Basin in Hastings and Castleton Townships, Barry County, Michigan

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    When the Thornapple Basin Survey program commenced in 1979, the Barry County site files indicated the presence of only 64 archaeological sites in this area of the state. However, it was also quite apparent from the available data in the site files as well as from information provided by the Michigan History Division that no program of systematic archaeological research had ever been conducted in the county. And, clearly, this was a situation that the MHD desired to have remedied. Aside from the interest expressed by the State Archaeologist, Dr. John Halsey, and his staff in having a program of systematic site location survey initiated in the Thornapple River Basin, the senior author, Dr. William Cremin of Western Michigan University, also was anxious to expand WMU\u27s survey activities beyond the nearby Kalamazoo River Basin. After four years of systematic survey in portions of this drainage, Cremin recognized the need for creating a data set for comparison with the growing body of information generated by the Kalamazoo Basin Survey a need which has only increased with the recent completion of this survey program. Now, with a data set derived from more than 350 prehistoric sites occurring in 135 km of the basin surveyed, it has become absolutely essential that comparative information from other drainages in southern Lower Michigan be made available in order that predictive models of prehistoric settlement and subsistence behavior emerging for this universe (and other areas in this portion of the state) might be rigorously tested. With this thought in mind, and responding to the request of MHD that a proposal be submitted for initiating site survey in the Thornapple River Valley, Cremin and his associates began a literature/documents search and examination of the Barry County site files, evaluated the available information, and established a series of research objectives to guide TBS Phase I activities in 1979 as well as to provide a basis for long term systematic survey in this universe in future years

    Collaborative writing with young people with disabilities: raising new questions of authorship and agency

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    The process of communication between author and reader is a critical issue in examining any text. When considering the communication of ideas from young people whose voices are seldom heard, the journey from author to audience has particular significance. The construction of children and young people as ‘authors’ is important, especially for those with learning difficulties or who struggle to comply with the current emphasis on spelling, punctuation and grammar. This article relates to a UK Research-Council-funded three-year collaborative research project involving the co-creation of fictional stories with young people with disabilities to represent aspects of their lives. Drawing on frameworks from narratology, I analyse the co-creation of one of the stories, and present an interpretation and elaboration of the discourse structure of narrative fiction to illustrate the complexities of the relationship between the multi-faceted ‘author’ and community ‘reader’ of these stories. The combination of qualitative research and fictional prose has particular characteristics and implications for the dissemination and communication of research findings; while extending feminist critique of Barthes’ claim for the death of the author provides new insights for engaging children in writing with their own voice

    Patterns of self-reported behaviour change associated with receiving voluntary counselling and testing in a longitudinal study from Manicaland, Zimbabwe.

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    Voluntary counselling and testing (VCT) is promoted as a potential HIV prevention measure. We describe trends in uptake of VCT for HIV, and patterns of subsequent behaviour change associated with receiving VCT in a population-based open cohort in Manicaland, Zimbabwe. The relationship between receipt of VCT and subsequent reported behaviour was analysed using generalized linear models with random effects. At the third survey, 8.6% of participants (1,079/12,533), had previously received VCT. Women who received VCT, both those positive and negative, reduced their reported number of new partners. Among those testing positive, this risk reduction was enhanced with time since testing. Among men, no behavioural risk reduction associated with VCT was observed. Significant increases in consistent condom use, with regular or non-regular partners, following VCT, were not observed. This study suggests that, among women, particularly those who are infected, behavioural risk reduction does occur following VCT

    Simple models of the chemical field around swimming plankton

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    Background. Cervical cancer is the fourth most common cancer in women, and we recently reported human leukocyte antigen (HLA) alleles showing strong associations with cervical neoplasia risk and protection. HLA ligands are recognized by killer immunoglobulin-like receptors (KIRs) expressed on a range of immune cell subsets, governing their proinflammatory activity. We hypothesized that the inheritance of particular HLA-KIR combinations would increase cervical neoplasia risk. Methods. Here, we used HLA and KIR dosages imputed from single-nucleotide polymorphism genotype data from 2143 cervical neoplasia cases and 13 858 healthy controls of European decent. Results. The following 4 novel HLA alleles were identified in association with cervical neoplasia, owing to their linkage disequilibrium with known cervical neoplasia-associated HLA-DRB1 alleles: HLA-DRB3*9901 (odds ratio [OR], 1.24; P = 2.49 × 10−9), HLA-DRB5*0101 (OR, 1.29; P = 2.26 × 10−8), HLA-DRB5*9901 (OR, 0.77; P = 1.90 × 10−9), and HLA-DRB3*0301 (OR, 0.63; P = 4.06 × 10−5). We also found that homozygosity of HLA-C1 group alleles is a protective factor for human papillomavirus type 16 (HPV16)-related cervical neoplasia (C1/C1; OR, 0.79; P = .005). This protective association was restricted to carriers of either KIR2DL2 (OR, 0.67; P = .00045) or KIR2DS2 (OR, 0.69; P = .0006). Conclusions. Our findings suggest that HLA-C1 group alleles play a role in protecting against HPV16-related cervical neoplasia, mainly through a KIR-mediated mechanism

    Teaching Writing: a situated dynamic

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    publication-status: Publishedtypes: ArticleThe paper is theoretically grounded in Cultural Historical Activity Theory (CHAT) which holds that human development is founded within participation in social and cultural practices. In particular, the teaching of literacy is shaped not only by the curriculum as designated by policy makers and the institution in which it is located but also by the individuals’ understanding of what literacy and learning involves and how they act to achieve their goals. The paper explores data from a project that investigated the relationship between classroom talk and the teaching of writing in six early years classrooms. Participants’ own understandings of teaching and learning need to be taken into account by researchers and policy makers. CHAT has been used to explore the dynamic relationship between activity at societal, institutional and individual levels. It is argued that researchers and policy makers need to take account of the wider socio-cultural context in planning and evaluating curriculum development initiatives
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