Search

Given advances in care and treatment for HIV, perinatally infected young people are surviving into adolescence. These young people are making decisions about engaging in sexual relationships and it is critical to ensure they have the information they need to engage responsibly in sexual activity, particularly in an era where adherence to treatment could make their virus undetectable. The main objective of this analysis was to examine whether an HIV-positive young person's knowledge about forward transmission is associated with caregiver self-efficacy to talk about sex and general caregiver communication. Using data from a 12-month prospective cohort of caregivers of HIV-positive children aged 9–15 on ART and pre-ART in rural Zimbabwe, we found that caregiver self-efficacy to talk about sex predicted whether conversations about HIV transmission would occur between caregiver and the young person. However, by the end of 12-months, nearly two-thirds of caregivers of HIV-positive teenagers in our sample had still not explained how their adolescents could spread the virus to others despite these caregivers saying their adolescent should know this information at baseline. We discuss the implications for designing sexual and reproductive health (SRH) programs among populations of young people perinatally infected with HIV to ensure that this breakthrough generation receives the SRH support they need. [ABSTRACT FROM AUTHOR]

Purpose: Suspension syndrome describes a potentially life-threatening event during passive suspension on a rope. The pathophysiological mechanism is not fully understood and optimal treatment unknown. We aimed to elucidate the pathophysiology and to give treatment recommendations.Methods: In this experimental, randomized crossover trial, 20 healthy volunteers were suspended in a sit harness for a maximum of 60 min, with and without prior climbing. Venous pooling was assessed by measuring the diameter of the superficial femoral vein (SFV), lower leg tissue oxygenation (StO2) and by determining localized bioelectrical impedance. Hemodynamic response was assessed by measuring heart rate, blood pressure, stroke volume, and left ventricular diameters. Signs and symptoms of pre-syncope were recorded.Results: Twelve (30%) out of 40 tests were prematurely terminated due to pre-syncopal symptoms (mean 44.7 min, minimum 13.4, maximum 59.7). SFV diameter increased, StO2 and the capacitive resistance of the cells decreased indicating venous pooling. Heart rate and blood pressure did not change in participants without pre-syncope. In contrast, in participants experiencing pre-syncope, heart rate and blood pressure dropped immediately before the event. All symptoms dissolved and values returned to normal within 5 min with participants in a supine position.Conclusions: Sudden pre-syncope during passive suspension in a harness was observed in 30% of the tests. Blood pools in the veins of the lower legs; however, a vagal mechanism finally leads to loss of consciousness. Time to pre-syncope is unpredictable and persons suspended on a rope should be rescued and put into a supine position as soon as possible. [ABSTRACT FROM AUTHOR]

Background In the present study, we set out to compare patient-reported outcomes with professional judgment about cosmesis after breast-conserving therapy (bct) and to evaluate which items (position of the nipple, color, scar, size, shape, and firmness) correlate best with subjective outcome. Methods Dutch patients treated with bct between 2008 and 2009 were analyzed. Exclusion criteria were prior amputation or bct of the contralateral breast, metastatic disease, local recurrence, or any prior cosmetic breast surgery. Structured questionnaires and standardized six-view photographs were obtained with a minimum of 3 years' follow-up. Cosmetic outcome was judged by the patients and, based on photographs, by 5 different medical professionals using 3 different scoring systems: the Harvard scale, the Sneeuw questionnaire, and a numeric rating scale. Agreement was scored using the intraclass correlation coefficient (icc). The association between items of the Sneeuw questionnaire and a fair-poor Harvard score was estimated using logistic regression analysis. Results The study included 108 female patients (age: 40-91 years). Based on the Harvard scale, agreement on cosmetic outcome between the professionals was good (icc: 0.78). In contrast, agreement between professionals as a group compared with the patients was found to be fair to moderate (icc range: 0.38-0.50). The items "size" and "shape" were identified as the strongest determinants of cosmetic outcome. Conclusions Cosmetic outcome was scored differently by patients and professionals. Agreement was greater between the professionals than between the patients and the professionals as a group. In general, size and shape were the most prominent items on which cosmetic outcome was judged by patients and professionals alike. [ABSTRACT FROM AUTHOR]

Due to increased organizational dependence on information systems technology, the effectiveness of the systems analyst is more crucial today than ever. Despite technological advances that have increased the number and quality of tools available to systems analysts, the individual analyst's problem-solving skills remain key to defining good systems requirements. Understanding how expert analysts approach the requirements analysis task may provide insights for improving the effectiveness of novice analysts. This paper examines differences in the problem-solving approaches of novice and expert systems analysts during an information requirements task. Specific weaknesses that set novice and expert analysts apart are identified, and techniques that may be used to strengthen novice skills are suggested. This research supports the current literature on creativity techniques as a strategy for strengthening system analysis skills. [ABSTRACT FROM AUTHOR]

Referees are an integral part of soccer, and their performance is fundamental for regular match flow, irrespective of the competition level or age classes. So far, scientific interest was mainly limited to aspects of exercise physiology and match performance of soccer referees, whereas recommendations for nutrition were adopted from active professional soccer. In contrast to elite soccer players, most referees are non‐professional and engaged in different occupations. Furthermore, elite referees and soccer players differ in regard to age, body composition, aerobic capacity, and training load. Thus, referees' caloric needs and recommended daily carbohydrate intake may generally be lower compared to active soccer players, with higher intakes limited to periods of increased training load and match days or for referees engaged in physical demanding occupations. With respect to fluid intake, pre‐match and in‐match hydration strategies generally valid in sports are recommended also for referees to avoid cognitive and physical performance loss, especially when officiating in extreme climates and altitude. In contrast to elite soccer, professional assistance concerning nutrition and training is rarely available for national elite referees of most countries. Therefore, special attention on education about adequate nutrition and fluid intake, about the dietary prevention of deficiencies (iron in female referees, vitamin D irrespective of sex and age), and basic precautions for travels abroad is warranted. In conclusion, the simple adoption of nutritional considerations from active soccer for referees may not be appropriate. Recommendations should respect gender differences, population‐specific physical characteristics, and demands just as well as individual characteristics and special needs. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this pilot study was to evaluate surface contamination by platinum drugs in the environment of patients in ICUs and wards treated by hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: The monitoring included 12 HIPEC treatments from four hospitals during the following 3 days after perfusion. A total of 33 urine and 33 drainage fluids from HIPEC patients and 160 wipe samples from several surfaces (urine/drainage bags, floors, gloves) were taken during the study period. Results: In urine, the highest platinum concentrations were measured on the first day after perfusion. Median platinum concentrations were 1260 ng/ml for patients after cisplatin perfusion and 11,000 ng/ml for oxaliplatin treatment. Concentrations decreased until day three to 413 ng/ml cisplatin and 529 ng/ml oxaliplatin, respectively. In drainage liquids, platinum concentrations were generally lower. Platinum concentrations from surfaces of bags and floors ranged from 0.01 to 439 pg/cm (median: urine bag 2.77 pg/cm, drainage bag 0.22 pg/cm, floor left 0.14 pg/cm, floor right 0.24 pg/cm), with the highest contamination found on the outer surface of the urine bags. Samples from nurses' protective gloves ranged between 0.03 and 12 pg/cm (median: 0.2 pg/cm). Conclusions: High platinum-drug concentrations in urine and drainage liquids are the main source of contamination. Therefore, safe handling of these liquids is the best way to avoid cross-contamination on surfaces in wards and ICUs. Our results show that it is possible to take care of HIPEC patients without high contaminations during the first 3 days. [ABSTRACT FROM AUTHOR]

Copyright of Operative Orthopädie und Traumatologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We investigated the effects of two 5-wk periods of intermittent hypoxia on running economy (RE). 11 male and female middle-distance runners were randomly assigned to the intermittent hypoxia group (IHG) or to the control group (CG). All athletes trained for a 13-wk period starting at pre-season until the competition season. The IHG spent additionally 2 h at rest on 3 days/wk for the first and the last 5 weeks in normobaric hypoxia (15-11% FiO2). RE, haematological parameters and body composition were determined at low altitude (600m) at baseline, after the 5th, the 8th and the 13th week of training. RE, determined by the relative oxygen consumption during submaximal running, (-2.3±1.2 vs. -0.3±0.7 ml/min/kg, P<0.05) and total running time ( + 1.0±0.9 vs. +0.4±0.5min, P<0.05) changed significantly between the IHG and CG only during the first 5-wk period. Haematological and cardiorespiratory changes indicate that the improved RE was associated with decreased cardiorespiratory costs and greater reliance on carbohydrate. Intermittent hypoxia did not affect RE during the second 5-wk period. These findings suggest that the effects of intermittent hypoxia on RE strongly depend on the training phase. [ABSTRACT FROM AUTHOR]

This study explores how communities in Zambia characterize vulnerable children in the context of HIV; demonstrates how estimates of vulnerability vary depending on definitions; and discusses the implications of these estimates for program delivery. Baseline research conducted in 2005 included cross-sectional community-based household surveys at six locations using multi-stage random sampling (totalling 1,503 households, reporting on 5,009 children) and participatory qualitative research (focus group and in-depth interviews) with adults and youth at four locations. Between 14 and 27% of children in the sample had experienced a parental death (2-5% maternal orphans, 7-13% paternal orphans, 4-10% double orphans). In addition, other characteristics that communities associated with children's vulnerability were prevalent: 26-34% had been taken into another household, 15-27% were living in female-headed households, and 11-28% were living in a household with someone who is chronically ill. Overall, 58-73% of children had one or more community-defined characteristics of vulnerability. This study highlights the need to carefully consider the meaning of “vulnerability” when targeting programmes to support children affected by HIV and AIDS. Local community input is vital to inform context-specific criteria for distributing programme resources. If used, eligibility criteria should be context-specific yet flexible to evolving community realities. In settings such as rural Zambia where levels of HIV-related vulnerability are high, it may be more efficient to target at the level of communities rather than assess individual households. [ABSTRACT FROM AUTHOR]

OBJECTIVE: In response to findings from a statewide survey of hospital nurses, the authors designed, conducted, and evaluated a 'Back to Sleep' nursing curriculum and training program in Missouri hospitals using two distinct training formats. This article evaluates the initial and follow-up outcomes for training participants and assesses the impact of training format on participant outcomes. METHODS: Participants selected training format by hospital site. In each training format, participants responded to a pre and post test questionnaire measuring knowledge, beliefs, and current infant care behaviors as well as satisfaction with the training. Three months after completion of all statewide trainings, the authors also conducted a follow-up survey. RESULTS: Nurses who participated in the training reported statistically significant improvements in knowledge and 'Back to Sleep' adherent beliefs. Over 98% of participants (N = 515) intended to place infants in back-only sleep positions following the training. Knowledge, attitudes, and practice intentions were significantly improved across both training formats. Additionally, follow-up survey respondents statewide (N = 295) reported lasting improvements, including 63% of nurses reportedly using supine-only sleep position for infants after the first 24 h of life, compared to 28% in the original statewide survey. CONCLUSIONS: Further research is needed to determine the long-term impact of this intervention and assess its applicability beyond this initial implementation. Ultimately, the findings from the evaluation of this pilot intervention and nursing-specific 'Back to Sleep' curriculum demonstrate that it has a promising effect on risk-reduction adherence in hospital settings where parent observations of safe sleep behavior first occur. [ABSTRACT FROM AUTHOR]

Copyright of Der Orthopäde is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study assessed the strategy of building young people's capacity to provide care and support to people living with HIV and AIDS in rural Zambia. Members of youth anti-AIDS clubs in schools and communities were trained as adjunct caregivers using a locally developed curriculum that allowed them to explore and challenge gendered notions of caregiving and emphasized networking with existing resources. Results show that caregiving increased among males (47% to 82%) and females (41% to 78%). Both sexes provided similar caregiving services, including help with household chores and personal care tasks. Youth also undertook activities with children to decrease their isolation, help them stay in school, and reach additional services. While clients and caregivers reported positive aspects of the programme, both reported frustration with the youths’ inability to meet material needs. This study demonstrates that trained youth already involved in anti-AIDS efforts can meet a range of care needs and be valuable assets to their community. It also highlights the importance of communicating clearly what youth can and cannot do, ongoing monitoring and support of youth caregivers, and involving community leaders to give youth credibility and access to local resources. [ABSTRACT FROM AUTHOR]

This paper describes the implementation of a large community-based HIV/AIDS behavioural intervention in rural Uganda and presents 4 years' worth of quantitative process data. The intervention involved 560 field-based workers (57% male, 76% subsistence farmers, mean age 35 years), supervised by six central staff. Intervention channels included drama and video shows, Community Educators (CEs), as well as leaflet and condom distribution. Activities focused on one or more of 16 key topics. In total, 392 000 attendances (51% female) were recorded—a mean of over 6 for each of the 64 000 target adults—at 81 000 activities, with CEs attracting 71% of the total attendance; 164 000 leaflets and 242 000 condoms were also distributed. The annual cost of the intervention per target individual was approximately US$1.76. Our voluntary workforce experienced an annual attrition rate of 11%, with 'stable' workers more likely to be older, married or opinion leaders in their community than those who dropped out. We calculate that even a significant increase in the proportion of female field workers would have made little difference either to the sex ratio of attendees or to overall attendance. In spite of some initial resistance to the intervention, particularly in relation to condoms, we have demonstrated that people in rural Africa can accept and actively participate in the dissemination of HIV/AIDS prevention messages throughout their own communities. [ABSTRACT FROM AUTHOR]

We study finite-size effects in the self-organized critical forest-fire model by numerically evaluating the tree density and the fire size distribution. The results show that this model does not display the finite-size scaling seen in conventional critical systems. Rather, the system is composed of relatively homogeneous patches of different tree densities, leading to two qualitatively different types of fires: those that span an entire patch and those that do not. As the system size becomes smaller, the system contains less patches, and finally becomes homogeneous, with large density fluctuations in time. [ABSTRACT FROM AUTHOR]

Mutation induction was investigated in wild-type haploid yeast Sacchaomyces cerevisiae after split-dose UV-irradiation. Cells were exposed to fractionated 254 nm-UV-doses separated by intervals from 0 to 6 h with incubation either on non-nutrient or nutrient agar between. The test parameter was resistance to canavanine. If modifications of sensitivity due to incubation are appropriately taken into account there is no change of mutation frequency. [ABSTRACT FROM AUTHOR]

Copyright of Der Chirurg is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Klinische Wochenschrift is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The human resources (HR) function at Westinghouse needed to find a way to get full value out of their corporate human resources and payroll system. Ad hoc reporting and retrieval of important HR information was often laborious and difficult. Implementing an executive information system (EIS) made the Westinghouse HR and payroll system easily accessible and a value-added source of information. We examined the implementation and ongoing use of the human resources basic information environment (HuRBIE) at Westinghouse, focusing on how the addition of HuRBIE affects employees' information gathering for the HR community. Our investigation provides some insights into different sources of information at Westinghouse, EIS as an information source, and how customer information needs are addressed. Such customer surveys can be used to determine customer needs and to manage change in the EIS. [ABSTRACT FROM AUTHOR]

From September 1983 to December 1985 40 patients from a total of 55 with periampullary and pancreatic head carcinoma underwent resectional surgery in our department. Following a policy of precise evaluation of each patient's operative findings, six patients underwent a Whipple duodenopancreatectomy, 29 patients underwent regional subtotal pancreatectomy, and five underwent regional total pancreatectomy. Five patients underwent vascular reconstruction of their regional vascular structures after transection of the invaded segments of their vessels and eight had positive lymph nodes. Lymph node involvement was confined to the regional area. Patients with distant lymph node involvement (paraaortic) were not considered eligible to resection. Three patients died and 10 required reoperation. Thirty-one had radical resection, one palliative and eight equivocal resection. From the survived patients (n = 37) 33 are alive and doing well at the time of this report (overall mean survival 18 months). The results of this study demonstrate that a radical approach based on a precise evaluation of operative findings of the individual patient might well offer a higher resectability rate and is probably the only chance for radical resection and for a longer survival in patients with periampullary and pancreatic head carcinoma. [ABSTRACT FROM AUTHOR]

Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Virchows Archiv A Pathological Anatomy & Histology is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The original version of this article unfortunately contained a mistake. Information was missing in the acknowledgements section. The correct information is given below. [ABSTRACT FROM AUTHOR]

Copyright of Klinische Wochenschrift is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)