The Shc adaptor protein and its role on Her -2 /neu oncogenesis

Shc proteins are implicated in coupling receptor tyrosine kinases to the mitogen-activated protein kinase (MAPK) pathway by recruiting Grb2/SOS to the plasma membrane. To better understand the role of Shc in oncogenesis brought about by point mutation activated neu (p185*), we transfected a Shc mutant (ShcΔCH1), which lacks the Grb2 binding site Y317 by deletion of collagen-homology domain 1, into p185*-transformed NIH3T3 cells. The cellular transformation phenotypes were found to be largely suppressed by expression of ShcΔCH1. This study indicates that Shc plays a critical role in mediating the oncogenical signals of p185*. Although ShcΔCH1 still retained another Grb2 binding site (Y239/240), we did not detect its physical association with Grb2. We also found that ShcΔCH1 could associate with p185*; however, this association did not interfere with the endogenous Shc-p185* interaction or the Shc-Grb2 interaction. In addition, p185*-mediated MAPK/Elk activation, PI3-K activation and Src activation likewise was not inhibited by ShcΔCH1 expression. Taken together, our current study clearly indicates that ShcΔCH1 suppresses the p185*-induced transformation, and that this suppression is mediated through a MAPK-independent and possibly PI3-K, Src-independent pathway. These results suggest that Shc may be involved in other unidentified signal pathways which are critical for p185*-induced cellular transformation besides the three pathways that we have studied. ^

El análisis de la construcción sin pérdidas (Lean Construction) y su relación con el Project & Construction Management : propuesta de regulación en España y su inclusión en la ley de la ordenación de la edificación

El presente trabajo se basa en la filosofía de la Construcción sin Pérdidas (“Lean Construction”), analizando la situación de esta filosofía en el sector de la edificación en el contexto internacional y español, respondiendo las siguientes preguntas: 1. ¿Cómo surge el “Lean Construction”? 2. ¿Cuáles son sus actividades, funciones y cometidos? 3. ¿Existe regulación del ¨Lean Construction” en otros países? 4. ¿Existe demanda del ¨Lean Construction” en España? 5. ¿Existe regulación del ¨Lean Construction” en España? 6. ¿Cómo debería ser la regulación ¨Lean Construction” en España? 7. ¿Cuál es la relación del “Lean Construction” con el “Project & Construction Management”? 8. ¿Cómo debería ser la regulación de “Lean Construction” en España considerando su relación con el “Project & Construction Management”? Las preguntas indicadas las hemos respondido detalladamente en el presente trabajo, a continuación se resume las respuestas a dichas preguntas: 1. El “Lean Construction” surge en agosto de 1992, cuando el investigador finlandés Lauri Koskela publicó en la Universidad de Stanford el reporte TECHNICAL REPORT N° 72 titulado “Application of the New Production Philosophy to Construction”. Un año más tarde el Dr. Koskela invitó a un grupo de especialistas en construcción al primer workshop de esta materia en Finlandia, dando origen al International Group for Lean Construction (IGLC) lo que ha permitido extender la filosofía a EEUU, Europa, América, Asia, Oceanía y África. “Lean Construction” es un sistema basado en el enfoque “Lean Production” desarrollado en Japón por Toyota Motors a partir de los años cincuenta, sistema que permitió a sus fábricas producir unidades con mayor eficiencia que las industrias americanas, con menores recursos, en menor tiempo, y con un número menor de errores de fabricación. 2. El sistema “Lean Construction” busca maximizar el valor y disminuir las pérdidas de los proyectos generando una coordinación eficiente entre los involucrados, manejando un proyecto como un sistema de producción, estrechando la colaboración entre los participantes de los proyectos, capacitándoles y empoderándoles, fomentando una cultura de cambio. Su propósito es desarrollar un proceso de construcción en el que no hayan accidentes, ni daños a equipos, instalaciones, entorno y comunidad, que se realice en conformidad con los requerimientos contractuales, sin defectos, en el plazo requerido, respetando los costes presupuestados y con un claro enfoque en la eliminación o reducción de las pérdidas, es decir, las actividades que no generen beneficios. El “Last Planner System”, o “Sistema del Último Planificador”, es un sistema del “Lean Construction” que por su propia naturaleza protege a la planificación y, por ende, ayuda a maximizar el valor y minimizar las pérdidas, optimizando de manera sustancial los sistemas de seguridad y salud. El “Lean Construction” se inició como un concepto enfocado a la ejecución de las obras, posteriormente se aplicó la filosofía a todas las etapas del proyecto. Actualmente considera el desarrollo total de un proyecto, desde que nace la idea hasta la culminación de la obra y puesta en marcha, considerando el ciclo de vida completo del proyecto. Es una filosofía de gestión, metodologías de trabajo y una cultura empresarial orientada a la eficiencia de los procesos y flujos. La filosofía “Lean Construction” se está expandiendo en todo el mundo, además está creciendo en su alcance, influyendo en la gestión contractual de los proyectos. Su primera evolución consistió en la creación del sistema “Lean Project Delivery System”, que es el concepto global de desarrollo de proyectos. Posteriormente, se proponen el “Target Value Design”, que consiste en diseñar de forma colaborativa para alcanzar los costes y el valor requerido, y el “Integrated Project Delivery”, en relación con sistemas de contratos relacionales (colaborativos) integrados, distintos a los contratos convencionales. 3. Se verificó que no existe regulación específica del ¨Lean Construction” en otros países, en otras palabras, no existe el agente con el nombre específico de “Especialista en Lean Construction” o similar, en consecuencia, es un agente adicional en el proyecto de la edificación, cuyas funciones y cometidos se pueden solapar con los del “Project Manager”, “Construction Manager”, “Contract Manager”, “Safety Manager”, entre otros. Sin embargo, se comprobó la existencia de formatos privados de contratos colaborativos de Integrated Project Delivery, los cuales podrían ser tomados como unas primeras referencias para futuras regulaciones. 4. Se verificó que sí existe demanda del ¨Lean Construction” en el desarrollo del presente trabajo, aunque aún su uso es incipiente, cada día existe más interesados en el tema. 5. No existe regulación del ¨Lean Construction” en España. 6. Uno de los objetivos fundamentales de esta tesis es el de regular esta figura cuando actúe en un proyecto, definir y realizar una estructura de Agente de la Edificación, según la Ley de Ordenación de la Edificación (LOE), y de esta manera poder introducirla dentro de la Legislación Española, protegiéndola de eventuales responsabilidades civiles. En España existe jurisprudencia (sentencias de los tribunales de justicia españoles) con jurisdicción civil basada en la LOE para absolver o condenar a agentes de la edificación que son definidos en los tribunales como “gestores constructivos” o similares. Por este motivo, en un futuro los tribunales podrían dictaminar responsabilidades solidarias entre el especialista “Lean Construction” y otros agentes del proyecto, dependiendo de sus actuaciones, y según se implemente el “Lean Project Delivery System”, el “Target Value Design” y el “Integrated Project Delivery”. Por otro lado, es posible que el nivel de actuación del especialista “Lean Construcción” pueda abarcar la gestión del diseño, la gestión de la ejecución material (construcción), la gestión de contratos, o la gestión integral de todo el proyecto de edificación, esto último, en concordancia con la última Norma ISO 21500:2012 o UNE-ISO 21500:2013 Directrices para la dirección y gestión de proyectos. En consecuencia, se debería incorporar adecuadamente a uno o más agentes de la edificación en la LOE de acuerdo a sus funciones y responsabilidades según los niveles de actuación del “Especialista en Lean Construction”. Se propone la creación de los siguientes agentes: Gestor del Diseño, Gestor Constructivo y Gestor de Contratos, cuyas definiciones están desarrolladas en este trabajo. Estas figuras son definidas de manera general, puesto que cualquier “Project Manager” o “DIPE”, gestor BIM (Building Information Modeling), o similar, puede actuar como uno o varios de ellos. También se propone la creación del agente “Gestor de la Construcción sin Pérdidas”, como aquel agente que asume las actuaciones del “gestor de diseño”, “gestor constructivo” y “gestor de contratos” con un enfoque en los principios del Lean Production. 7. En la tesis se demuestra, por medio del uso de la ISO 21500, que ambos sistemas son complementarios, de manera que los proyectos pueden tener ambos enfoques y ser compatibilizados. Un proyecto que use el “Project & Construction Management” puede perfectamente apoyarse en las herramientas y técnicas del “Lean Construction” para asegurar la eliminación o reducción de las pérdidas, es decir, las actividades que no generen valor, diseñando el sistema de producción, el sistema de diseño o el sistema de contratos. 8. Se debería incorporar adecuadamente al agente de la edificación “Especialista en Lean Construction” o similar y al agente ¨Especialista en Project & Construction Management” o DIPE en la Ley de Ordenación de la Edificación (LOE) de acuerdo a sus funciones y responsabilidades, puesto que la jurisprudencia se ha basado para absolver o condenar en la referida Ley. Uno de los objetivos fundamentales de esta tesis es el de regular la figura del “Especialista en Lean Construction” cuando actúa simultáneamente con el DIPE, y realizar una estructura de Agente de la Edificación según la LOE, y de esta manera protegerlo de eventuales responsabilidades solidarias. Esta investigación comprueba que la propuesta de definición del agente de edificación DIPE, según la LOE, presentada en la tesis doctoral del Doctor Manuel Soler Severino es compatible con las nuevas definiciones propuestas. El agente DIPE puede asumir los roles de los diferentes gestores propuestos en esta tesis si es que se especializa en dichas materias, o, si lo estima pertinente, recomendar sus contrataciones. ABSTRACT This work is based on the Lean Construction philosophy; an analysis is made herein with regard to the situation of this philosophy in the building sector within the international and Spanish context, replying to the following questions: 1. How did the concept of Lean Construction emerge? 2. Which are the activities, functions and objectives of Lean Construction? 3. Are there regulations on Lean Construction in other countries? 4. Is there a demand for Lean Construction in Spain? 5. Are there regulations on Lean Construction in Spain? 6. How should regulations on Lean Construction be developed in Spain? 7. What is the relationship between Lean Construction and the Project & Construction Management? 8. How should regulations on Lean Construction be developed in Spain considering its relationship with the Project & Construction Management? We have answered these questions in detail here and the replies are summarized as follows: 1. The concept of Lean Construction emerged in august of 1992, when Finnish researcher Lauri Koskela published in Stanford University TECHNICAL REPORT N° 72 entitled “Application of the New Production Philosophy to Construction”. A year later, Professor Koskela invited a group of construction specialists to Finland to the first workshop conducted on this matter; thus, the International Group for Lean Construction (IGLC) was established, which has contributed to extending the philosophy to the United States, Europe, the Americas, Asia, Oceania, and Africa. Lean Construction is a system based on the Lean Production approach, which was developed in Japan by Toyota Motors in the 1950s. Thanks to this system, the Toyota plants were able to produce more units, with greater efficiency than the American industry, less resources, in less time, and with fewer manufacturing errors. 2. The Lean Construction system aims at maximizing the value of projects while reducing waste, producing an effective coordination among those involved; it manages projects as a production system, enhancing collaboration between the parties that participate in the projects while building their capacities, empowering them, and promoting a culture of change. Its purpose is to develop a construction process free of accidents, without damages to the equipment, facilities, environment and community, flawless, in accordance with contractual requirements, within the terms established, respecting budgeted costs, and with a clear approach to eliminating or reducing waste, that is, activities that do not generate benefits. The Last Planner System is a Lean Construction system, which by its own nature protects planning and, therefore, helps to maximize the value and minimize waste, optimizing substantially the safety and health systems. Lean Construction started as a concept focused on the execution of works, and subsequently the philosophy was applied to all the stages of the project. At present it considers the project’s total development, since the time ideas are born until the completion and start-up of the work, taking into account the entire life cycle of the project. It is a philosophy of management, work methodologies, and entrepreneurial culture aimed at the effectiveness of processes and flows. The Lean Construction philosophy is extending all over the world and its scope is becoming broader, having greater influence on the contractual management of projects. It evolved initially through the creation of the Lean Project Delivery System, a global project development concept. Later on, the Target Value Design was developed, based on collaborative design to achieve the costs and value required, as well as the Integrated Project Delivery, in connection with integrated relational (collaborative) contract systems, as opposed to conventional contracts. 3. It was verified that no specific regulations on Lean Construction exist in other countries, in other words, there are no agents with the specific name of “Lean Construction Specialist” or other similar names; therefore, it is an additional agent in building projects, which functions and objectives can overlap those of the Project Manager, Construction Manager, Contract Manager, or Safety Manager, among others. However, the existence of private collaborative contracts of Integrated Project Delivery was confirmed, which could be considered as first references for future regulations. 4. There is a demand for Lean Construction in the development of this work; even though it is still emerging, there is a growing interest in this topic. 5. There are no regulations on Lean Construction in Spain. 6. One of the main objectives of this thesis is to regulate this role when acting in a project, and to define and develop a Building Agent structure, according to the Building Standards Law (LOE by its acronym in Spanish), in order to be able to incorporate it into the Spanish law, protecting it from civil liabilities. In Spain there is jurisprudence in civil jurisdiction based on the LOE to acquit or convict building agents, which are defined in the courts as “construction managers” or similar. For this reason, courts could establish in the future joint and several liabilities between the Lean Construction Specialist and other agents of the project, depending on their actions and based on the implementation of the Lean Project Delivery System, the Target Value Design, and the Integrated Project Delivery. On the other hand, it is possible that the level of action of the Lean Construction Specialist may comprise design management, construction management and contract management, or the integral management of the entire building project in accordance with the last ISO 21500:2012 or UNE-ISO 21500:2013, guidelines for the management of projects. Accordingly, one or more building agents should be appropriately incorporated into the LOE according to their functions and responsibilities and based on the levels of action of the Lean Construction Specialist. The creation of the following agents is proposed: Design Manager, Construction Manager, and Contract Manager, which definitions are developed in this work. These agents are defined in general, since any Project Manager or DIPE, Building Information Modeling (BIM) Manager or similar, may act as one or as many of them. The creation of the Lean Construction Manager is also proposed, as the agent that takes on the role of the Design Manager, Construction Manager and Contract Manager with a focus on the Lean Production principles. 7. In the thesis it is demonstrated that through the implementation of the ISO 21500, both systems are supplementary, so projects may have both approaches and be compatible. A project that applies the Project & Construction Management may perfectly have the support of the tools, techniques and practices of Lean Construction to ensure the elimination or reduction of losses, that is, those activities that do not generate value, thus designing the production system, the design system, or the contract system. 8. The Lean Construction Specialist or similar and the Specialist in Project & Construction Management should be incorporated appropriately into the LOE according to their functions and responsibilities, since jurisprudence has been based on such Law to acquit or convict. One of the main objectives of this thesis is the regulate the role of the Lean Construction Specialist when acting simultaneously with the DIPE, and to develop a structure of the building agent, according to the LOE, and in this way protect such agent from joint and several liabilities. This research proves that the proposal to define the DIPE building agent, according to the LOE, and presented in the doctoral dissertation of Manuel Soler Severino, Ph.D. is compatible with the new definitions proposed. The DIPE agent may assume the roles of the different managers proposed in this thesis if he specializes in those topics or, if deemed pertinent, recommends that they be engaged.

Co-morbidity burden in Parkinson’s disease : Comparison with controls and its influence on prognosis

Open Access funded by Parkinson's UK Financial support: This study was funded by Parkinson’s UK, the Scottish Chief Scientist Office, NHS Grampian endowments, the BMA Doris Hillier award, RS Macdonald Trust, the BUPA Foundation, and SPRING. The funders had no involvement in the study. We acknowledge funding for the PINE study from Parkinson’s UK (G-0502, G-0914 G-1302), the Scottish Chief Scientist Office (CAF/12/05), the BMA Doris Hillier award, RS Macdonald Trust, the BUPA Foundation, NHS Grampian endowments and SPRING. We thank the patients and controls for their participation and the research staff who collected data and supported the study database.

Genetic diversity of Plasmodium falciparum histidine-rich protein 2 (PfHRP2) and its effect on the performance of PfHRP2-based rapid diagnostic tests

Rising costs of antimalarial agents are increasing the demand for accurate diagnosis of malaria. Rapid diagnostic tests (RDTs) offer great potential to improve the diagnosis of malaria, particularly in remote areas. Many RDTs are based on the detection of Plasmodium falciparum histidine-rich protein (PfHRP) 2, but reports from field tests have questioned their sensitivity and reliability. We hypothesize that the variability in the results of PfHRP2-based RDTs is related to the variability in the target antigen. We tested this hypothesis by examining the genetic diversity of PfHRP2, which includes numerous amino acid repeats, in 75 P. falciparum lines and isolates originating from 19 countries and testing a subset of parasites by use of 2 PfHRP2-based RDTs. We observed extensive diversity in PfHRP2 sequences, both within and between countries. Logistic regression analysis indicated that 2 types of repeats were predictive of RDT detection sensitivity (87.5% accuracy), with predictions suggesting that only 84% of P. falciparum parasites in the Asia-Pacific region are likely to be detected at densities

Clinical supervision: Its influence on client-rated working alliance and client symptom reduction in the brief treatment of major depression

Supervision of psychotherapists and counselors, especially in the early years of practice, is widely accepted as being important for professional development and to ensure optimal client outcomes. Although the process of clinical supervision has been extensively studied, less is known about the impact of supervision on psychotherapy practice and client symptom outcome. This study evaluated the impact of clinical supervision on client working alliance and symptom reduction in the brief treatment of major depression. The authors randomly assigned 127 clients with a diagnosis of major depression to 127 supervised or unsupervised therapists to receive eight sessions of problems-solving treatment. Supervised therapists were randomly assigned to either alliance skill- or alliance process-focused supervision and received eight supervision sessions. Before beginning treatment, therapists received one supervision session for brief training in the working alliance supervision approach and in specific characteristics of each case. Standard measures of therapeutic alliance and symptom change were used as dependent variables. The results showed a significant effect for both supervision conditions on working alliance from the first session of therapy, symptom reduction, and treatment retention and evaluation but no effect differences between supervision conditions. It was not possible to separate the effects of supervision from the single pretreatment session and is possible that allegiance effects might have inflated results. The scientific and clinical relevance of these findings is discussed.

The contagion of international terrorism and its effects on the firm in an interconnected world

International trade and investment economies are highly integrated and interdependent and can be exploited by organized, international terrorism. The network of inter dependencies in the international economy means that a terrorist attack has the potential to disrupt the functioning of the network, so the effects can reverberate around the world. Governments can control the distributed effects of terrorism by auditing industrial networks to reveal and protect critical hubs and by promoting flexibility in production and distribution of goods and services to improve resilience in the economy. To explain these network effects, the authors draw on the new science of complex networks which has been applied to the physical sciences and is now increasingly being used to explain organizational and economic phenomena.

Creating demand for better health by using social marketing techniques

The most significant environmental change to support people who want to give up smoking is the legislation to ban smoking in public places. Following Scotland in March 2006, and Wales and Northern Ireland in April 2007, England moves one step closer to being smoke free on 1 July 2007, when it becomes illegal to smoke in almost every enclosed public place and workplace. Social marketing will be used to support this health promoting policy and will become more prominent in the design of health promotion campaigns of the future. Social marketing is not a new approach to promoting health but its adoption by the Government does represent a paradigm shift in the challenge to change public opinion and social norms. As a result some behaviours, like smoking or excessive alcohol consumption, will no longer be socially acceptable. The Department of Health has decided that social marketing should be used in England to guide all future health promotion efforts directed at achieving behavioural goals. This paradigm shift was announced in Chapter 2 of the “Choosing health” White Paper with its emphasis on the consumer, noting that a wide range of lifestyle choices are marketed to people, although health as a commodity itself has not been marketed. The DoH has an internal social marketing development unit to integrate social marketing principles into its work and ensure that providers deliver. The National Centre for Social Marketing has funding to provide ongoing support, to build capacity and capability in the workforce. This article describes the distinguishing features of the social marketing approach. It seeks to answer some questions. Is this really a new idea, a paradigm shift, or simply a change in terminology? What do the marketing principles offer that is new, or are they merely familiar ideas repackaged in marketing jargon? Will these principles be more effective than current health promotion practice and, if so, how does it work? Finally, what are the implications for community pharmacy?

The new UK research governance: its impact on pharmacy undergraduate research projects

Implementation of the Department of Health Research Governance Framework (RGF) in the United Kingdom has major implications for the conduct of pharmacy practice undergraduate research projects. This paper draws upon a survey of local ethics research committees (LRECs) in the greater Birmingham area to identify the issues that arise from the RGF in relation to non-clinical practice research in community pharmacy. Although there is some evidence of minor differences between LRECs, the overwhelming finding is that projects will be subject to the full force of the RGF. The implications are discussed in relation to specific issues relating to non-clinical research, the professional aspirations for a research capable workforce, and the expertise within pharmacy to meet the current accreditation requirements for undergraduate projects.

Genomic variation of HIV-1 and its effects on drug resistance and molecular epidemiology analyses

In the first part of this study human immunodeficiency virus type 1 (HIV-1) proviral DNA sequences derived from 201 clones of the C2-V3 env region and the first exon of the tat gene were obtained from six MV-1 infected heterosexual couples. These molecular data were used to confirm the epidemiological relationships. The ability of the molecular data to draw such conclusions was also tested with multiple phylogenetic analyses. The tat region was much more useful in establishing epidemiological relationships than the commonly used C2-V3.^ Subsequently, using nucleotide sequences from the first exon of the Tat gene, we tested the hypothesis that a Florida dentist (a common source) infected five of his patients in the course of dental procedures, against the null hypothesis that the dentist and each individual of the dental group independently acquired the virus within the local community. Multiple phylogenetic analyses demonstrated that the sequences of the five patients were significantly more related to each other than to sequences of the controls. Our results using Tat sequences, combined with envelope sequence data, strongly support a common phylogenetic epidemiological relationship among these five patients.^ A third study is presented, which deals with the effects of genomic variations in drug resistance. HIV-1 reverse transcriptase (RT) mutations were detected in DNA from peripheral blood mononuclear cells from 11 of 12 HIV-infected children after 11-20 months of zidovudine monotherapy. The codon 41/215 mutant combination was associated with general decline in health status. Patients developing the codon 70 mutation tended to have a better health status. ^

Nurses' spiritual well-being: Its influence on attitudes and level of practice in providing spiritual care

The purpose of this study was to examine the relationship between the spiritual well-being of nurses and its influence on their attitudes toward providing spiritual care to patients. Two research instruments and a demographic data form were used for the survey. Using a descriptive design, tbe Spiritual Well-Being Scale, the Health Professional's Spiritual Role Scale, and the demographic data form were administered to 100 registered nurses from a large South Florida teaching hospital. The findings indicated a significantly positive correlation between the overall Spiritual Well-Being Scale and the Health Professional's Spiritual Role Scale (r = 0.52; p =.005). Significant differences were found between correlation of nurses' levels of spiritual well-being and all sociodemographic factors except for the three Age Groups and for religious affiliations. Findings have implications for how nurses should be trained in meeting patients total needs. ^

Stapedotomy and its effect on hearing – our experience with 54 cases.

Introduction: This study reviews the cases of stapedotomy and evaluates its effectiveness at improving hearing loss in patients with otosclerosis. Materials and methods: Retrospective review of patients’ records who had clinical and audiometric diagnosis of otosclerosis from January to December 2012. Results: A total of 54 stapedotomy surgeries (52 unilateral and 1 bilateral surgeries) were received. Average post-operative ABG for 0.5, 1, 2 and 4 KHz showed that 61.1% had complete closure of ABG (ABG < 10 dB) compared with 1.6% preoperatively and 85.2% had closure of ABG to within 20dB compared with 4.7% preoperatively (t – 13.89, p = 0.000). More than 94% had hearing improvement and 81.5% had ABG closure greater than 10 dB postoperatively (mean gain 23.38 ± 12.37, t = 13.89, p = 0.000). A total of 13% complications were recorded with TM perforation (5.6%) being the commonest complication. Conclusion: Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patients’ quality of life. A favorable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and appropriate surgical technique.

NUTRITION AND HEALTH STATUS OF HIV-INFECTED ADULTS ON ARVS AT AMREF CLINIC KIBERA URBAN SLUM, KENYA

The health of people living with HIV and AIDS (PLWHA) is nutritionally challenged in many nations of the world. The scourge has reduced socio-economic progress globally and more so in sub-Saharan Africa (SSA) where its impact has been compounded by poverty and food insecurity. Good nutrition with proper drug use improves the quality of life for those infected but it is not known how PLWHA exposed to chronic malnutrition and food shortages from developing nations adjust their nutrition with use of Anti-Retro-viral Drugs (ARVs). This study assessed nutritional status, dietary practices, and dietary management of common illnesses that hinder daily food intake by the patients and use of ARVs with food recommendations provided by the health care givers. A descriptive case study design was used to sample 120 HIV-infected patients using systematic sampling procedure. These patients sought health care from an urban slum, Kibera AMREF clinic. Data were collected by anthropometric measurements, bio-chemical analysis, semi-structured questionnaire and secondary data. The Statistical Package for Social Sciences (SPSS) and the Nutri-Survey software packages were used to analyze data. Dietary intakes of micro-nutrients were inadequate for >70% of the patients when compared to the Recommended Daily Requirements. When Body Mass Indices (BMI) were used, only 6.7% of the respondents were underweight (BMI<18.5kg/m2) and 9.2% were overweight (BMI> 25kg/m2), serum albumin test results (mean 3.34±0.06g/dl) showed 60.8% of the respondents were protein deficient and this was confirmed by low dietary protein intakes. The BMI was not related to dietary nutrient intakes, serum albumin and CD4 cell counts (p>0.05). It appeared that there was no significant difference in BMI readings at different categories of CD4 cell count (p>0.05) suggesting that the level of immunity did not affect weight gain with ARV as observed in many studies from developed countries. Malnutrition was, therefore, evident among the 60.8% of the cases as identified by serum albumin tests and food intake was not adequate (68%) for the patients as they ate once a day due to lack of food. National food and nutrition policy should incorporate food security boosting guidelines for the poor people infected with HIV and using ARVs.