Clinical learning environment is a very important aspect of nursing teaching. In Europe as well as USA, the principle of nursing education is based on a 50% theoretical class work and 50% practical through clinical experience. In Kenya, the learning is different where 69.5% is class work and 21.5% is the clinical area placement. Kenya government designed a one-year internship for all BScN students before they are entered into nursing council register to give the student enough experience before they enter into the field. Clinical learning is described as the "heart" of professional practice. Practice placement constitutes an important aspect of students` learning through influencing students' acquisition of skills and knowledge for quality care provision in the right environments. The future of nursing profession is based on capacitating the student nurse with the ability to make critical decision at work. Noteworthy, many aspects affect student learning in clinical placement. Among them is shortage of qualified staff which is the case in the study area-Mathare Teaching and Referral Hospital. This study focused on factors that influence students learning in the clinical placement and aimed to determine the effect of student's perspectives and staff attitude towards learning in placement areas on learning among bachelor of nursing (BScN) students. A self-administered questionnaire was used to collect data that was analyzed by using statistical package of social sciences (SPSS) version 20. Study findings were presented by use of tables, charts and text. The findings revealed that most students (64.8%) were pursuing nursing training out of individual choice and felt that nursing was a calling to them but some (25.9%) would go to another career given a chance. Most (61.1%) students were apprehensive about clinical placement and the work they would be involved in. Reception in the hospital department by supervision staff was generally fairly satisfactory however 5.6% students reported lack of satisfaction. Nursing staff in the clinical area were generally friendly and concerned; and staff supervision in the clinical area was generally helpful and caring but not always available. The clinical placement areas need to enhance nurse-under-placement and receptors relationship to enhance uptake of the real life experience of the nursing profession.

Adherence to antiretroviral therapy is a major predictor of the survival of individuals living with HIV/AIDS.Appropriate use of antiretroviral drugs (ARVs) has improved the health of many HIV positive individuals. The effectiveness of HIV treatment depends on sustenance of high levels of adherence to ARVs, however, ARV regimens are often complicated and can be affected by varying dosing schedules, failing to have proper dietary requirements and patients developing adverse effects. The main objective of this study was to determine patient's demographic, social and economic factors influencing adherence to Anti-retroviral drugs among HIV/AIDS adult patients. A cross sectional study was carried out at Embu County Teaching and Referral Hospital in Kenya. Stratified random sampling was used to obtain relative proportion of male and female respondents. 332 HIV positive patients were chosen from a total of 1694 patients who were active in ART for more than one year. A semi-structured interview schedules was used to obtain information. The study revealed that almost half (48.2%) of the respondents had optimal adherence to ART treatment. 34.9% cited traveling as an hindrance to optimal adherence to treatment. Adherence to ART treatment was significantly associated with age of the respondents, marital status, main occupation and average monthly income of the respondents. The study recommends that HIV patients should be given more information on the importance of consistency and nearly perfect adherence to ART. The patients should be enlightened on the importance of carrying their ARV drugs even when going for short travels.

Abstract:Adherence to antiretroviral therapy is a major predictor of the survival of individuals living with HIV/AIDS. Appropriate use of antiretroviral (ARV's) has improved the health of many human immunodeficiency virus (HIV) positive individuals. The effectiveness of HIV treatment depends on sustenance of high levels of adherence to ARV; however, ARV regimens are often complicated and can be affected by varying dosing schedules, failing to have proper dietary requirements and patients developing adverse effects. The objective of this study was to determine therapy and health system related factors influencing adherence to Anti-retroviral drugs among adult HIV/ AIDS patients in Embu County Teaching and Referral Hospital Comprehensive Care Clinic. The study applied cross sectional descriptive design with stratified random sampling used to obtain relative proportion of male and female adult respondents in the sample population. 332 HIV positive patients were chosen from a total of 1694 patients who were active in ART for more than one year. A semi-structured interview schedules was used to obtain patients view on various dimension or ART services at the facility. ART adherence was at 48.2%. There was significant association between adherence to ART treatment and the type of drug a respondent was in with AZT, ddl, NFV having the highest proportion of sub-optimal adherence to treatment while respondents on D4T, 3TC, NVP had the lowest proportion of sub-optimal adherence to treatment. Convenience of the facilities for people with chronic ailments and waiting time at the facilities were reported to be good (73.0%) and excellent (75.3%) respectively.